Individual
DR. VICKI L ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
512 SKYLINE BLVD, CLOQUET, MN 55720-1199
(218) 879-4641
(218) 879-8904
Mailing address
512 SKYLINE BLVD, CLOQUET, MN 55720-1199
(218) 879-4641
(218) 879-8904
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22662
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119768
MEDICA
MN
05
—
204287800
—
MN
01
—
550T0AN
BLUES & FIRST PLAN
MN
Enumeration date
10/19/2006
Last updated
08/07/2019
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