Individual
MRS. JESSICA J ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Mailing address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
71010855
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001513579
BCBS
—
01
—
2020093423
BOARD CERT
IN
05
—
30048075
—
IN
05
—
7100725430
—
KY
01
—
71010855
INDIANA STATE LICENSE
IN
Enumeration date
10/22/2020
Last updated
02/08/2024
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