Individual
KATHRYN D ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
2620 S WESTERN AVE, MARION, IN 46953-3556
(765) 573-2530
(765) 573-2535
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002537A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000542597
ANTHEM, BLUE CROSS BLUE SHIELD
—
05
—
200882340
—
IN
Enumeration date
10/29/2007
Last updated
12/02/2025
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