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General NPI Number Information
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NPI Number | 1568859452
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Entity Type | Individual
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Provider Name | TAWANNA ANDERSON-LEADER APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 150 SW 12TH AVE
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3298
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Country | US
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Telephone | 954-773-9596
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Fax |
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Provider Business Mailing Address
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Address Line | 740 SW 94TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-1151
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Country | US
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Telephone | 754-234-4534
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 9164439
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN9164439
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License Number State | FL
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