Individual
JUDI L ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
512 MAIN AVE, LAKE NORDEN, SD 57248-0079
(605) 785-3633
(605) 785-3946
Mailing address
PO BOX 79, LAKE NORDEN, SD 57248-0079
(605) 785-3633
(605) 785-3946
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R031664
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5300462
—
SD
Enumeration date
01/13/2006
Last updated
05/08/2008
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