Individual
KENNETH STEPHEN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
201 STATE ST, ERIE, PA 16550-0002
(814) 877-2080
(814) 877-6070
Mailing address
1442 BIEBEL AVE, ERIE, PA 16509-2846
(814) 864-7775
(814) 877-6070
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
RN187319L
PA
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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