Healthcare Provider Details

I. General information

NPI: 1336062728
Provider Name (Legal Business Name): ANITA JINDANI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 N 7TH ST
PHOENIX AZ
85014-5005
US

IV. Provider business mailing address

4073 E YUCCA ST
PHOENIX AZ
85028-2921
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-6797
  • Fax:
Mailing address:
  • Phone: 612-325-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number321753
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: