Individual
ANGELICA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
429 W WALNUT ST, LEBANON, KY 40033-1346
(270) 295-1010
Mailing address
546 CLELL MATTINGLY RD, RAYWICK, KY 40060-7573
(270) 295-1010
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4026321
KY
363LP2300X
Primary Care Nurse Practitioner
4026321
KY
Other
Enumeration date
08/15/2024
Last updated
01/07/2025
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