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NPI Code Detail

MEDICARE: BEATRICE MARIE ANDERSON APRN

MEDICARE: BEATRICE MARIE ANDERSON APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner209018442IL
2363L00000XNurse Practitioner209.018442IL

General Provider Information

NPI Number : 1104394493
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEATRICE MARIE ANDERSON APRN
Provider Business Mailing Address
First Line : 214 EAGLE DR
Second Line :
City : COVINGTON
State : IN
Zip : 47932-8504
Country : US
Telephone Number : 217-260-1433
Fax Number :
Provider Business Practice Location Address
First Line : 3545 N VERMILION ST
Second Line :
City : DANVILLE
State : IL
Zip : 61832-1100
Country : US
Telephone Number : 217-651-6801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2018
Last Update Date : 04/03/2025

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Directions to “ BEATRICE MARIE ANDERSON APRN” Practice Location

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