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General NPI Number Information
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NPI Number | 1669889820
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Entity Type | Individual
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Provider Name | CHRISTOPHER J ANDERSON APRN FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/18/2014
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 495 GOLD STAR HWY STE 112
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City | GROTON
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State | CT
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Zip | 06340-6229
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Country | US
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Telephone | 860-245-4123
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Fax | 877-927-0171
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Provider Business Mailing Address
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Address Line | 495 GOLD STAR HWY STE 112
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City | GROTON
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State | CT
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Zip | 06340-6229
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Country | US
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Telephone | 860-245-4126
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Fax | 877-927-0171
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 005820
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License Number State | CT
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