Individual
MRS. CAROLYN CLOUD ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6633
(913) 684-6128
Mailing address
2406 S 22ND ST, LEAVENWORTH, KS 66048-4074
(913) 651-0107
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
14-44693-102
KS
Other
Enumeration date
11/23/2005
Last updated
07/08/2007
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