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NPI Code Detail

MEDICARE: IVY ANDERSON

MEDICARE: IVY 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
1163WG0000XGeneral Practice Registered Nurse2520735MN

General Provider Information

NPI Number : 1639012974
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVY ANDERSON
Provider Business Mailing Address
First Line : 1 VETERANS DR
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55417-2309
Country : US
Telephone Number : 612-725-2000
Fax Number :
Provider Business Practice Location Address
First Line : 1 VETERANS DR
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55417-2309
Country : US
Telephone Number : 612-725-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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Directions to “ IVY ANDERSON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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