Individual
JUDITH M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
7649 ODELL CIRCLE NE, OTSEGO, MN 55330
(920) 750-9799
Mailing address
7649 ODELL CIRCLE NE, OTSEGO, MN 55330
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1170-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43953300
—
WI
01
—
500024022
RR MEDICARE
—
Enumeration date
07/06/2006
Last updated
08/05/2019
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