MEDICARE: TAWNYA ANDERSON FNP

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	363LF0000X	Family Nurse Practitioner	AP127408	TX

General Provider Information

NPI Number	:	1376920041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAWNYA ANDERSON FNP

Provider Business Mailing Address
First Line	:	1801 S GULFWAY DR
Second Line	:
City	:	PORT ARTHUR
State	:	TX
Zip	:	77640-4416
Country	:	US
Telephone Number	:	409-985-1819
Fax Number	:	409-985-1079

Provider Business Practice Location Address
First Line	:	1801 S GULFWAY DR
Second Line	:
City	:	PORT ARTHUR
State	:	TX
Zip	:	77640-4416
Country	:	US
Telephone Number	:	409-985-1819
Fax Number	:	409-985-1079

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

Provider Enumeration Date	:	05/01/2015
Last Update Date	:	12/23/2025

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