Individual
GRETCHEN L ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CS, MS(N),FNP
Contact information
Practice address
3917 WEST RD, SUITE A, LOS ALAMOS, NM 87544-2275
(505) 661-8900
(505) 661-8961
Mailing address
3917 WEST RD, SUITE A, LOS ALAMOS, NM 87544-2275
(505) 661-8900
(505) 661-8961
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
102429
MO
363LF0000X
Family Nurse Practitioner
Primary
CNP-01819
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
429664626
—
MO
Enumeration date
01/25/2006
Last updated
01/30/2012
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