Individual
MRS. AMORETTE LEANN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
234 LAKE ST, ROSCOMMON, MI 48653-9203
(989) 275-1200
(989) 275-1210
Mailing address
234 LAKE ST, ROSCOMMON, MI 48653-9203
(989) 275-1200
(989) 275-1210
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
999
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704205103
MICHIGAN STATE LICENSE
MI
01
—
999
STATE LICENSE
AK
05
—
CL1391
—
AK
Enumeration date
10/17/2007
Last updated
08/24/2020
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