Individual
ANDREA J ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 EDMUNDSON PL STE 100, COUNCIL BLUFFS, IA 51503-4658
(717) 322-4136
(717) 322-8129
Mailing address
8632 S 99TH CIR, LA VISTA, NE 68128-7009
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A154365
IA
363LP0200X
Pediatric Nurse Practitioner
112780
NE
Other
Enumeration date
05/30/2019
Last updated
02/10/2023
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