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NPI Code Detail

MEDICARE: MRS. STEPHANIE ANN ANDERSON

MEDICARE: MRS. STEPHANIE ANN ANDERSON
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 Practitioner34575TN

General Provider Information

NPI Number : 1205611597
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEPHANIE ANN ANDERSON
Provider Business Mailing Address
First Line : ONE GI CREDENTIALING DEPARTMENT
Second Line : PO BOX 381468
City : GERMANTOWN
State : TN
Zip : 38183-1468
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8000 WOLF RIVER BLVD STE 200
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-1755
Country : US
Telephone Number : 901-747-3630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2023
Last Update Date : 12/08/2025

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Directions to “ MRS. STEPHANIE ANN ANDERSON ” Practice Location

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