Healthcare Provider Details

I. General information

NPI: 1992300750
Provider Name (Legal Business Name): ANNA PLOTKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N CAMPBELL AVE
TUCSON AZ
85719-4330
US

IV. Provider business mailing address

2437 N LIGHTNING A DR
TUCSON AZ
85749-7920
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-0111
  • Fax:
Mailing address:
  • Phone: 714-296-4336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001286310
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1044690
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number262304
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR238403
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: