Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | R126603-4 | MN |
NPI | 1003883182 |
---|---|
Provider Name | Chara J Anderson |
First Address | Saint Paul, MN 55114-2001 |
Second Address | Burnsville, MN 55337-6749 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 14/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0413227 | MEDICA (01) | MN |
1021486 | PREFERREDONE (01) | MN |
127465 | UCARE (01) | MN |
406274400 | (05) | MD |
43941700 | (05) | WI |
47B02AN | BLUE CROSS/BLUE SHIELD (01) | MN |
585814300 | (05) | MN |
925677 | AMERICA'S PPO (01) | MN |
HP29538 | HEALTHPARTNERS (01) | MN |
S94603 | (02) | MN |