Individual
ELISHA D ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
819 MAIN ST, LISBON, ND 58054-4244
(701) 683-4134
(701) 683-4094
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 683-4134
(701) 683-4094
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R30898
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84045
—
ND
Enumeration date
02/17/2011
Last updated
04/24/2012
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