MEDICARE: JULIA M ANDERSON ARNP

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	363LA2200X	Adult Health Nurse Practitioner	19301	SC
2	363LA2200X	Adult Health Nurse Practitioner	ARNP 9203897	FL

General Provider Information

NPI Number	:	1255360566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA M ANDERSON ARNP

Provider Business Mailing Address
First Line	:	PO BOX 751649
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1649
Country	:	US
Telephone Number	:	843-789-1620
Fax Number	:	843-724-2440

Provider Business Practice Location Address
First Line	:	2097 HENRY TECKLENBURG DR STE 201W
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5739
Country	:	US
Telephone Number	:	843-402-1211
Fax Number	:	843-606-8088

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	10/24/2019

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