Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | R 210222-3 | MN |
NPI | 1003167610 |
---|---|
Provider Name | Barbara E Anderson |
First Address | Rochester, MN 55905-0001 |
Second Address | Denver, CO 80204-4507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2012 |
Last Update Date | 16/03/2021 |