Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 0101052842 | VA |
N | 207RA0401X | Internist - Addiction Medicine | 0101052842 | VA |
NPI | 1487622502 |
---|---|
Provider Name | Dr. Kathleen Hess Anderson |
First Address | Cincinnati, OH 45202-1457 |
Second Address | Norfolk, VA 23502-3920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 10/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005850258 | (05) | VA |
G68982 | (02) |