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Individual
MARY RUTH ANDERSON
Active
Individual
MARY RUTH ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
733590
TX
363LF0000X
Family Nurse Practitioner
Primary
AP120985
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200444810 A
—
OK
05
—
288384502
—
TX
05
—
35539861
—
NM
Enumeration date
11/06/2011
Last updated
05/13/2020
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