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Individual

BRENDA ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, APRN, CNP

Contact information

Practice address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(612) 720-5550
Mailing address
19998 ENFIELD AVE N, FOREST LAKE, MN 55025-8068
(612) 720-5550

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2459812
MN
363LG0600X
Gerontology Nurse Practitioner
Primary
11571
MN
363LP2300X
Primary Care Nurse Practitioner
Primary
11571
MN

Other

Enumeration date
02/23/2024
Last updated
04/03/2026
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