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General NPI Number Information
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NPI Number | 1841866712
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Entity Type | Individual
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Provider Name | ALICIA NICOLE ANDERSON DO
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Gender | Female
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Dates
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Enumeration Date | 06/01/2021
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 5555 W THUNDERBIRD RD
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City | GLENDALE
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State | AZ
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Zip | 85306-4622
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Country | US
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Telephone | 602-865-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 OAKLAND DR
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City | KALAMAZOO
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State | MI
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Zip | 49008-1282
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 010939
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License Number State | AZ
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