Individual
ANITA MARIE HANDEVIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CNP CNS
Contact information
Practice address
401 WEST ST, JACKSON, MN 56143-1219
(507) 847-2423
(507) 847-2422
Mailing address
117 S SPRING ST, PO BOX 686, LUVERNE, MN 56156-1916
(507) 283-9511
(507) 283-9514
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R0902409
MN
364S00000X
Clinical Nurse Specialist
Primary
R0902409
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164160
UCARE
MN
05
—
236135300
—
MN
01
—
374M2HA
BCBS
MN
Enumeration date
08/09/2006
Last updated
02/03/2017
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