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Individual

DR. MARY NELL ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7777 HENNESSY BLVD, STE 706, BATON ROUGE, LA 70808-4300
(225) 769-5554
(225) 757-1959
Mailing address
PO BOX 53904, LAFAYETTE, LA 70505-3904
(225) 769-5554

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
017212
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1375896
LA
Enumeration date
07/07/2006
Last updated
03/31/2008
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