MEDICARE: DR. FIONA SIAN ANDERSON PH.D., L. P.

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	103TC0700X	Clinical Psychologist	LP 4228	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1025767	OTHER	MN	PREFERRED ONE
2	1161843	OTHER	MN	ARAZ
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	151280	OTHER	MN	UCARE
9	024A7AN	OTHER	MN	BCBS
10	HP34568	OTHER	MN	HEALTHPARTNERS

General Provider Information

NPI Number	:	1043254675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FIONA SIAN ANDERSON PH.D., L. P.

Provider Business Mailing Address
First Line	:	5100 EDEN AVE STE 109
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55436-2333
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5100 EDEN AVE STE 109
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55436-2333
Country	:	US
Telephone Number	:	612-419-9832
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	11/04/2015

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