Provider Demographics
NPI:1871780759
Name:VAIL, ANNA ELIZABETH (ARNP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ELIZABETH
Last Name:VAIL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 32ND ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6917
Mailing Address - Country:US
Mailing Address - Phone:360-207-6119
Mailing Address - Fax:360-282-1268
Practice Address - Street 1:1205 32ND ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6917
Practice Address - Country:US
Practice Address - Phone:360-207-6119
Practice Address - Fax:360-282-1268
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60607172363LP0808X
OR200750128NP363LP0808X
CA753530163W00000X
CA19750363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse