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NPI Code Detail

MEDICARE: ASHANTI ANDERSON

MEDICARE: ASHANTI 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
1363LF0000XFamily Nurse Practitioner113035TX

General Provider Information

NPI Number : 1134823107
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHANTI ANDERSON
Provider Business Mailing Address
First Line : 1729 SAINT JAMES DR
Second Line :
City : CARROLLTON
State : TX
Zip : 75007-3028
Country : US
Telephone Number : 214-394-8915
Fax Number :
Provider Business Practice Location Address
First Line : 3737 GOLDMAN ST
Second Line :
City : DALLAS
State : TX
Zip : 75212-2471
Country : US
Telephone Number : 214-266-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2023
Last Update Date : 03/27/2023

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Directions to “ ASHANTI ANDERSON ” Practice Location

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