Healthcare Provider Details

I. General information

NPI: 1306389903
Provider Name (Legal Business Name): ANAHITA ANDERSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANAHITA MESHKANI-MEHDIAN FNP

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27A MEDICAL CENTER DR
JACKSON TN
38301-3949
US

IV. Provider business mailing address

PO BOX 381468
GERMANTOWN TN
38183-1468
US

V. Phone/Fax

Practice location:
  • Phone: 731-280-0157
  • Fax:
Mailing address:
  • Phone: 731-695-2165
  • Fax: 731-664-2175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN 0000021900
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: