Individual
JENNIFER ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2020 NEWBURG RD, LOUISVILLE, KY 40205-1803
(502) 261-2182
(502) 240-6481
Mailing address
10216 TAYLORSVILLE RD, SUITE 900, LOUISVILLE, KY 40299-3616
(502) 261-2182
(502) 240-6481
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA240
KY
363AM0700X
Medical Physician Assistant
PA240
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95000915
—
KY
Enumeration date
06/09/2006
Last updated
05/24/2021
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