Active NPI
Anita Etumnu, NP
- Primary Care Nurse Practitioner
- Lancaster, TX
National Provider Identifier
1306529128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 1111101
- Practice address
- 3200 W Pleasant Run Rd
Lancaster, TX 75146-1073 - Phone
- (888) 345-4666
- NPI assigned
- Aug 9, 2023
- Last updated
- Sep 14, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 1111101 | TX | Primary |
Addresses
Primary practice location
3200 W Pleasant Run Rd
Lancaster, TX 75146-1073
Mailing address
3200 W Pleasant Run Rd
Lancaster, TX 75146-1073
Phone (888) 345-4666
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1111101 | TX | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726272000000",
"number": "1306529128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 W PLEASANT RUN RD",
"city": "LANCASTER",
"state": "TX",
"postal_code": "751461073",
"telephone_number": "888-345-4666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 W PLEASANT RUN RD",
"city": "LANCASTER",
"state": "TX",
"postal_code": "751461073",
"telephone_number": "888-345-4666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETUMNU",
"first_name": "ANITA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-09",
"last_updated": "2024-09-14",
"certification_date": "2024-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "TX",
"license": "1111101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.