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General NPI Number Information
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NPI Number | 1457247421
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Entity Type | Individual
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Provider Name | MISTY DAWN ANDERSON FNP-C, APRN
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Gender | Female
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 230 LEXINGTON RD STE D
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City | LANCASTER
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State | KY
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Zip | 40444-6536
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Country | US
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Telephone | 859-304-5157
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Fax |
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Provider Business Mailing Address
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Address Line | 220 TANGLEWOOD DR
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City | SCIENCE HILL
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State | KY
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Zip | 42553-9208
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Country | US
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Telephone | 606-802-3921
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Fax |
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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 | 4042076
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License Number State | KY
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