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NPI Code Detail

MEDICARE: DR. JEANNE E. ANDERSON PSY.D.

MEDICARE:  DR. JEANNE E. ANDERSON  PSY.D.
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
1103TC0700XClinical Psychologist2212NC
2103T00000XPsychologist2212NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790966729
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEANNE E. ANDERSON PSY.D.
Provider Business Mailing Address
First Line : 606 WALTER REED DR STE B
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-1114
Country : US
Telephone Number : 336-547-1574
Fax Number : 336-323-5247
Provider Business Practice Location Address
First Line : 606 WALTER REED DR STE B
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-1114
Country : US
Telephone Number : 336-547-1574
Fax Number : 336-323-5247
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2007
Last Update Date : 11/27/2018

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