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General NPI Number Information
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NPI Number | 1265507750
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Entity Type | Individual
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Provider Name | SUE ANN ANDERSON MS,APRN, BC, FNP
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Gender | Female
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 209 FLORENCE AVE
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City | GRANGER
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State | IN
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Zip | 46530-8048
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Country | US
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Telephone | 574-246-1000
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Fax | 574-246-4000
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Provider Business Mailing Address
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Address Line | 52130 S LAKESHORE DR
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City | GRANGER
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State | IN
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Zip | 46530-7843
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Country | US
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Telephone | 574-273-9313
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Fax | 574-273-6261
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71000394A
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License Number State | IN
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