Provider Demographics
NPI:1871769273
Name:ANTHONY, KAY MARIE (RNP-C)
Entity type:Individual
Prefix:MRS
First Name:KAY
Middle Name:MARIE
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:RNP-C
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:MARIE
Other - Last Name:HERRINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNP-C
Mailing Address - Street 1:1803 OSTROM AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-3647
Mailing Address - Country:US
Mailing Address - Phone:562-773-5645
Mailing Address - Fax:
Practice Address - Street 1:400 W BROADWAY
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4401
Practice Address - Country:US
Practice Address - Phone:562-570-7113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA455355363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health