MEDICARE: KATHY M ANDERSON RN

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	163W00000X	Registered Nurse	RN169223	AZ

General Provider Information

NPI Number	:	1235068677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY M ANDERSON RN

Provider Business Mailing Address
First Line	:	2874 W PLACITA PACIENTE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-8733
Country	:	US
Telephone Number	:	814-241-1217
Fax Number	:

Provider Business Practice Location Address
First Line	:	2874 W PLACITA PACIENTE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-8733
Country	:	US
Telephone Number	:	814-241-1217
Fax Number	:

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

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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