Individual
AMY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 PORTLAND AVE, MC: 952, MINNEAPOLIS, MN 55415-1533
(612) 348-9840
(612) 596-7900
Mailing address
525 PORTLAND AVE, MC: 952, MINNEAPOLIS, MN 55415-1533
(612) 348-9840
(612) 596-7900
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R 093789-8
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0400623
MEDICA
MN
01
—
342842700
MEDICAL ASSISTANCE
MN
01
—
6982979
EVERCARE
MN
01
—
HP21014
HEALTHPARTNERS
MN
Enumeration date
08/05/2006
Last updated
04/15/2013
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