Individual
LYZA J ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
242 9TH AVENUE DR NE, HICKORY, NC 28601-3828
(828) 322-7305
Mailing address
1100 TROON RD, LAKE OSWEGO, OR 97034-2836
(404) 918-9019
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
201508616CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
RN144880
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
082191424A
PEACHSTATE CMO- MCCG
GA
05
—
082191424A
—
GA
01
—
344382
WELLCARE CMO - MCCG
GA
01
—
P00088939
RAILROAD MCR - MCCG
GA
Enumeration date
05/02/2007
Last updated
05/20/2016
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