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Individual

MRS. GINA LEANNE ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
3450 E FRANK PHILLIPS BLVD STE 200, BARTLESVILLE, OK 74006-2401
(918) 331-2445
(918) 331-2498
Mailing address
3450 E FRANK PHILLIPS BLVD STE 200, BARTLESVILLE, OK 74006-2401
(918) 331-2445
(918) 331-2498

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Q42098
KS
363LF0000X
Family Nurse Practitioner
Primary
125117
OK
363LF0000X
Family Nurse Practitioner
45682
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
161483
BLUE CROSS BLUE SHIELD
KS
05
200312350A
KS
01
925398
FIRST GUARD
KS
01
P00271606
RAILROAD MEDICARE
KS
Enumeration date
07/13/2006
Last updated
01/13/2020
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