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Individual

MR. KEITH ERIK ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, NP

Contact information

Practice address
550 MUNSON AVE, TRAVERSE CITY, MI 49686
(231) 935-2686
(231) 935-2687
Mailing address
2513 MOMENTUM PLACE, CHICAGO, IL 60689-0001
(231) 935-6080
(231) 935-6081

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
491898
CA
363LA2200X
Adult Health Nurse Practitioner
10439
CA
363LA2200X
Adult Health Nurse Practitioner
Primary
4704318195
MI

Other

Enumeration date
07/10/2006
Last updated
02/03/2022
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