Individual
MS. DIANE MICHELLE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1914
(201) 996-2218
Mailing address
978 BELLE AVE, TEANECK, NJ 07666-2613
(201) 370-4401
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00370800
NJ
Other
Enumeration date
04/19/2012
Last updated
04/19/2012
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