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General NPI Number Information
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NPI Number | 1619391364
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Entity Type | Individual
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Provider Name | HELEN ANDERSON FNPC
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Gender | Female
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Dates
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Enumeration Date | 02/14/2014
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | 520 8TH AVE NE
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City | DEMOTTE
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State | IN
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Zip | 46310-9108
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Country | US
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Telephone | 219-987-3581
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Fax |
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Provider Business Mailing Address
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Address Line | 7749 W 600 N
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City | FAIR OAKS
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State | IN
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Zip | 47943-8520
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Country | US
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Telephone |
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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 | F1113319
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License Number State | IN
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