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Individual
MRS. ELIZABETH E ANDERSON
Active
Individual
MRS. ELIZABETH E ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
073000
IA
363A00000X
Physician Assistant
Primary
1176
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098684468
MEDICARE PTAN
NE
Enumeration date
03/16/2006
Last updated
12/18/2019
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