Individual
MS. DORA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
(601) 362-5321
Mailing address
3502 W NORTHSIDE DR, JACKSON, MS 39213-4454
(601) 362-5321
(601) 362-5321
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R701564
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120569
—
MS
Enumeration date
06/13/2006
Last updated
07/09/2007
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