Individual
KATHY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6300 RIVERSIDE PLAZA LN NW STE 100, ALBUQUERQUE, NM 87120-1908
(505) 717-2449
Mailing address
6300 RIVERSIDE PLAZA LN NW STE 100, ALBUQUERQUE, NM 87120-1908
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
69944
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
618067800
DEEOIC
—
Enumeration date
11/02/2020
Last updated
11/02/2020
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