NPI 1063572014 · live from the CMS NPI Registry
Anna Liza Abastillas, APRN
Nurse Practitioner, Family in Southington, CT. National Provider Identifier 1063572014, active.
NPI record
| NPI | 1063572014 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Family 363LF0000X |
| Practice location | 360 14 N Main St, Southington, CT 06489 |
| Practice phone | 860-621-6759 |
| Mailing address | 9900 Bren Rd E, Minnetonka, MN 55343 |
| Enumerated | December 11, 2006 |
| Last updated | February 1, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 002935 (CT) |
| Nurse Practitioner, Family primary | 363LF0000X | 002935 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.