Individual
ELIZABETH ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1918 RANDOLPH RD, SUITE 400, CHARLOTTE, NC 28207-1100
(704) 384-9437
(704) 384-9440
Mailing address
PO BOX 10668, ALBANY, NY 12201-5668
(631) 422-6166
(631) 422-6266
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-03380
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-03380
NC LICENSE
NC
01
—
010580
NY LICENSE NUMBER
NY
Enumeration date
05/15/2006
Last updated
12/20/2016
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