Individual
KIMBERLY MARIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3800 SAINT MARY RD STE 102, VALPARAISO, IN 46383-3986
(219) 286-3707
(219) 286-3708
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209.019967
IL
363LF0000X
Family Nurse Practitioner
Primary
71008722A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300023556
—
IN
Enumeration date
01/09/2019
Last updated
01/12/2023
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