Individual
ELIZABETH A. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 331-3401
(812) 335-0027
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002465A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200873140
—
IN
Enumeration date
08/31/2007
Last updated
12/02/2020
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