Individual
LIANNE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, CNP
Contact information
Practice address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 351-4980
(618) 351-4940
Mailing address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 351-4980
(618) 351-4940
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209-010836
IL
363LA2200X
Adult Health Nurse Practitioner
Primary
201-010836
IL
363LG0600X
Gerontology Nurse Practitioner
209-010836
IL
363LP2300X
Primary Care Nurse Practitioner
209010836
IL
Other
Enumeration date
12/18/2013
Last updated
04/15/2014
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