Ana Bacic
Individual provider Active NPI Nurse Practitioner · Edmonds, WA
NPI 1003353483 · NPPES record last updated Jan 24, 2017
Key facts
- NPI
- 1003353483
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 60720095 (WA)
- Practice address
- 21600 Highway 99
Suite 260
Edmonds, WA 98026-8012 - Phone
- (425) 774-2650
- NPI assigned
- Jan 24, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60720095 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cellnetix Pathology, PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 60720095 | WA | Yes |
Addresses
Primary practice location
21600 Highway 99
Suite 260
Edmonds, WA 98026-8012
Mailing address
21600 Highway 99
Suite 260
Edmonds, WA 98026-8012
Phone (917) 566-1120
Other providers in Edmonds, WA
- Chimezie Leon Azuogu
- Casey Marie Dyer Babcock
- Judith Babcock
- Scott Allen Babin
- James R Babington
- Backman Colic & Patel PLLC
- Mary Baebler
- Marianna Baghdasaryan
- Paul Bagnulo
- Kathy Jo Baier
All providers in Edmonds, WA · Nurse Practitioner in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.