Individual
CARLOS ALEXANDER ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
312 PRINCE ST, SEVIERVILLE, TN 37862-3823
(865) 744-7684
Mailing address
10546 ARNOLD LANE, MASCOT, TN 37806
(865) 304-6774
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
210522
TN
363L00000X
Nurse Practitioner
Primary
24112
TN
Other
Enumeration date
06/03/2018
Last updated
06/03/2018
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