Individual
VICTORIA A ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA;( CCMA)
Contact information
Practice address
1387 N SHADELAND AVE STE E, INDIANAPOLIS, IN 46219-3605
(317) 361-6988
Mailing address
2040 N LUETT AVE, INDIANAPOLIS, IN 46222-2407
(317) 679-7188
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
IN
291U00000X
Clinical Medical Laboratory
Primary
15D2275815
IN
343900000X
Non-emergency Medical Transport (VAN)
—
IN
347C00000X
Private Vehicle
—
IN
3747A0650X
Attendant Care Provider
—
IN
374U00000X
Home Health Aide
000657
IN
374U00000X
Home Health Aide
21-015355-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210153551
—
IN
Enumeration date
08/09/2021
Last updated
04/24/2023
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