Individual
TERI ANNE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
1500 SALEM ST, LAFAYETTE, IN 47904-2164
(765) 448-8000
Mailing address
P.O. BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
CERT# 85145
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000558752
ANTHEM PROVIDER NUMBER
IN
Enumeration date
03/27/2008
Last updated
04/15/2008
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