Provider Demographics
NPI:1447461728
Name:SELLERS, ANITA DIANN (RN,BSN)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:DIANN
Last Name:SELLERS
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 S PLACITA PERLOZZO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-8227
Mailing Address - Country:US
Mailing Address - Phone:520-722-6053
Mailing Address - Fax:
Practice Address - Street 1:7450 E STELLA RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-2341
Practice Address - Country:US
Practice Address - Phone:520-584-6900
Practice Address - Fax:520-584-6901
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN-066843163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ765357Medicaid