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General NPI Number Information
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NPI Number | 1609871128
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Entity Type | Individual
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Provider Name | JUDITH S ANDERSON FNP
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Gender | Female
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 15210 L P BAILEY MEMORIAL HWY
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City | NATHALIE
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State | VA
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Zip | 24577-3304
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Country | US
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Telephone | 434-349-3113
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Fax | 434-349-2172
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Provider Business Mailing Address
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Address Line | 15210 L P BAILEY MEMORIAL HWY
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City | NATHALIE
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State | VA
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Zip | 24577-3304
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Country | US
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Telephone | 434-349-3113
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Fax | 434-349-2172
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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 | 0024050390
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License Number State | VA
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