MEDICARE: CHRISTINE ANDERSON NP-C

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	363L00000X	Nurse Practitioner	5007232	NC

General Provider Information

NPI Number	:	1053714006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE ANDERSON NP-C

Provider Business Mailing Address
First Line	:	315 TRENT DR
Second Line	:	ROOM 100
City	:	DURHAM
State	:	NC
Zip	:	27710-3038
Country	:	US
Telephone Number	:	919-681-5961
Fax Number	:	919-681-4637

Provider Business Practice Location Address
First Line	:	315 TRENT DR
Second Line	:	ROOM 100
City	:	DURHAM
State	:	NC
Zip	:	27710-3038
Country	:	US
Telephone Number	:	919-681-5961
Fax Number	:	919-681-4637

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

Provider Enumeration Date	:	10/06/2014
Last Update Date	:	11/16/2015

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