Individual
JENNIFER THERESE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1203 IDAHO ST, LEWISTON, ID 83501-1940
(509) 444-8200
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
72977
ID
363L00000X
Nurse Practitioner
RN00124469
WA
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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