MEDICARE: ANNE E. BUCHANAN INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	LP1741	MN

General Provider Information

NPI Number	:	1003924069
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANNE E. BUCHANAN INC

Provider Business Mailing Address
First Line	:	1420 E MINNEHAHA PKWY
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55417-1146
Country	:	US
Telephone Number	:	612-825-1695
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 E MINNEHAHA PKWY
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55417-1146
Country	:	US
Telephone Number	:	612-825-1695
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	MS. ANNE EILEEN BUCHANAN
Credential	:	M.S., L.P.
Telephone Number	:	612-825-1695

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	08/22/2020

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