Individual
LAUREN BROOKE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
181 POWELL VALLEY SCHOOL LN, SPEEDWELL, TN 37870-7431
(423) 419-5070
(423) 869-0081
Mailing address
181 POWELL VALLEY SCHOOL LN, SPEEDWELL, TN 37870-7431
(423) 419-5070
(423) 869-0081
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10001514A
IN
363A00000X
Physician Assistant
Primary
2028
TN
363A00000X
Physician Assistant
99056427A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340608
ANTHEM
IN
01
—
1487680518
GROUP NPI
IN
01
—
1629330923
GROUP NPI
TN
Enumeration date
08/16/2012
Last updated
03/17/2018
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