MEDICARE: ERIN LEIGH 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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1235878125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN LEIGH ANDERSON

Provider Business Mailing Address
First Line	:	PO BOX 1121
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97470-0254
Country	:	US
Telephone Number	:	541-672-2691
Fax Number	:

Provider Business Practice Location Address
First Line	:	29845 AIRPORT WAY
Second Line	:
City	:	GOLD BEACH
State	:	OR
Zip	:	97444-9744
Country	:	US
Telephone Number	:	541-780-9582
Fax Number	:

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

Provider Enumeration Date	:	05/31/2022
Last Update Date	:	05/31/2022

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Directions to “ ERIN LEIGH ANDERSON ” Practice Location

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