Individual
MRS. ELIZABETH E ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16909 LAKESIDE HILLS CT, SUITE 101, OMAHA, NE 68130-4664
(402) 398-5880
(402) 398-6716
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
(402) 398-5880
(402) 398-6716
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
073000
IA
363A00000X
Physician Assistant
Primary
1176
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098684468
MEDICARE PTAN
NE
Enumeration date
03/16/2006
Last updated
12/18/2019
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