Individual
STACEY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 KS HIGHWAY 264, LARNED, KS 67550-5353
(620) 285-2131
Mailing address
4060 N REED AVE APT 1628, MAIZE, KS 67101-3828
(316) 617-8908
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5380420052
KS
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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