Individual
GARY T. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
F.N.P.
Contact information
Practice address
204 LUNDORFF DR, SANDSTONE, MN 55072-5051
(320) 245-2250
(320) 245-2555
Mailing address
204 LUNDORFF DR, SANDSTONE, MN 55072-5051
(320) 245-2250
(320) 245-2555
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R 120278-4
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
827997700
—
MN
Enumeration date
05/27/2005
Last updated
12/04/2012
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