Individual
CODY LASHAY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4333 WESTERN CENTER BLVD, FORT WORTH, TX 76137-2036
(817) 232-1634
Mailing address
2004 EDMONIA CT, FORT WORTH, TX 76105-2821
(817) 209-9103
(281) 606-0354
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
912117
TX
163WP0200X
Pediatric Registered Nurse
912117
TX
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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