Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 718317 | TX |
NPI | 1043548860 |
---|---|
Provider Name | Julianne N Anderson |
First Address | Dallas, TX 75373-3784 |
Second Address | Fort Worth, TX 76104-2733 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2009 |
Last Update Date | 04/01/2022 |