Individual
JORDAN LILLIAN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10150 NIAGARA LN N # 100, MAPLE GROVE, MN 55369-7588
(224) 213-5886
Mailing address
10150 NIAGARA LN N # 100, MAPLE GROVE, MN 55369-7588
(224) 213-5886
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA15644
TX
363AS0400X
Surgical Physician Assistant
Primary
14483
MN
Other
Enumeration date
02/15/2022
Last updated
06/21/2023
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