Healthcare Provider Details

I. General information

NPI: 1033132162
Provider Name (Legal Business Name): ANNE R ANDERSON RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 10/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 W 65TH ST
EDINA MN
55435-1706
US

IV. Provider business mailing address

4200 DAHLBERG DR SUITE 300
GOLDEN VALLEY MN
55422-4840
US

V. Phone/Fax

Practice location:
  • Phone: 952-456-7000
  • Fax: 952-456-7001
Mailing address:
  • Phone: 952-512-5600
  • Fax: 952-512-5651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberR132219-8
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: