Healthcare Provider Details

I. General information

NPI: 1619745957
Provider Name (Legal Business Name): TEMPERANCE ANDREA ANDERSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 PROVIDENCE MAIN ST NW
HUNTSVILLE AL
35806-4815
US

IV. Provider business mailing address

103 LANWOOD DR
HUNTSVILLE AL
35811-6002
US

V. Phone/Fax

Practice location:
  • Phone: 256-830-9600
  • Fax:
Mailing address:
  • Phone: 256-830-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-135559
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: