Individual
ABBY L ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 205-4800
Mailing address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 205-4800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003712
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300027285
—
IN
Enumeration date
01/19/2006
Last updated
01/22/2021
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