Individual
DANIELLE MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
245 FOUNTAIN CT, STE 225, LEXINGTON, KY 40509
(859) 323-6021
(859) 323-1670
Mailing address
24 FOUNTAIN COURT, SUITE 225, LEXINGTON, KY 40509
(859) 323-6021
(859) 323-1670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
52880
KY
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
52880
KY
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
52880
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100547440
—
KY
Enumeration date
04/14/2017
Last updated
06/28/2021
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