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NPI Code Detail

MEDICARE: AUSTIN LANE ANDERSON FNP-BC

MEDICARE: AUSTIN LANE ANDERSON FNP-BC
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
1363LF0000XFamily Nurse Practitioner4027886KY

General Provider Information

NPI Number : 1487481842
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUSTIN LANE ANDERSON FNP-BC
Provider Business Mailing Address
First Line : 6178 COLLEGE STATION DR
Second Line :
City : WILLIAMSBURG
State : KY
Zip : 40769-1372
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 424 CHURCH ST STE 2600
Second Line :
City : NASHVILLE
State : TN
Zip : 37219-2379
Country : US
Telephone Number : 606-305-9892
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2024
Last Update Date : 11/01/2024

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