Individual
KELLY J. ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003119A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201013990
—
KY
05
—
300009768
—
IN
Enumeration date
11/19/2009
Last updated
12/01/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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