Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 25MA08247500 | NJ |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 25MA08247500 | NJ |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 58398 | GA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | N5598 | TX |
NPI | 1255520326 |
---|---|
Provider Name | Aiyanna B Anderson |
First Address | Fort Worth, TX 76104-2158 |
Second Address | Fort Worth, TX 76104-2158 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2007 |
Last Update Date | 10/10/2014 |