Provider Demographics
NPI:1023496908
Name:RINGERING, ANITA (NP)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:RINGERING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:
Other - Last Name:MUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:336 WARNER DR STE 4A
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-4441
Mailing Address - Country:US
Mailing Address - Phone:208-413-3835
Mailing Address - Fax:208-984-1068
Practice Address - Street 1:336 WARNER DR
Practice Address - Street 2:STE 4
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-4441
Practice Address - Country:US
Practice Address - Phone:208-413-3835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP-1581A363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1023496908OtherREGENCE BLUE SHIELD OF IDAHO
ID1023496908Medicaid
WA1023496908Medicaid
ID1023496908OtherBLUE CROSS OF IDAHO
WA1023496908Medicaid
ID1023496908Medicaid