Individual
MS. BIANCA MARIA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 773-2054
(928) 773-2286
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1031781
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
826172
—
AZ
Enumeration date
06/24/2013
Last updated
09/13/2017
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