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NPI Code Detail

MEDICARE: KATHERINE ROSE ANDERSON

MEDICARE: KATHERINE ROSE ANDERSON
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
1163WX0002XHigh-Risk Obstetric Registered Nurse229039AZ
2363LF0000XFamily Nurse Practitioner229039AZ

General Provider Information

NPI Number : 1134095169
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE ROSE ANDERSON
Provider Business Mailing Address
First Line : 1111 E MCDOWELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-2612
Country : US
Telephone Number : 602-839-2054
Fax Number :
Provider Business Practice Location Address
First Line : 1111 E MCDOWELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-2612
Country : US
Telephone Number : 602-839-2054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2025
Last Update Date : 12/01/2025

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Directions to “ KATHERINE ROSE ANDERSON ” Practice Location

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