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General NPI Number Information
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NPI Number | 1336950542
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Entity Type | Individual
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Provider Name | ANITHA JOHN NP
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Gender | Female
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 07/20/2025
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Provider Practice Location Address
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Address Line | 333 E BETHANY DR STE J100
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City | ALLEN
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State | TX
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Zip | 75002-3827
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Country | US
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Telephone | 512-887-5843
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Fax | 512-493-0485
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Provider Business Mailing Address
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Address Line | 1716 TRANSCENDENCE DR
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City | WYLIE
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State | TX
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Zip | 75098-0888
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Country | US
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Telephone | 720-724-8660
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1086730
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License Number State | TX
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