Healthcare Provider Details

I. General information

NPI: 1740560564
Provider Name (Legal Business Name): RACHEL ANN ANDERSON APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 HILES ST # 8039
LYNCHBURG TN
37352-8381
US

IV. Provider business mailing address

1055 WOMACK RIDGE RD
SHELBYVILLE TN
37160-8043
US

V. Phone/Fax

Practice location:
  • Phone: 931-808-4926
  • Fax:
Mailing address:
  • Phone: 931-808-4926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0000091524
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000016049
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License NumberNHA0000003209
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number16049
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: