MEDICARE: KATHRYN ANDERSON PA

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	363A00000X	Physician Assistant	5045	TN
2	363A00000X	Physician Assistant	PA5196	MA

General Provider Information

NPI Number	:	1831593003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN ANDERSON PA

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 THE VANDERBILT CLINIC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-1047
Country	:	US
Telephone Number	:	615-936-2000
Fax Number	:

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

Provider Enumeration Date	:	10/17/2014
Last Update Date	:	11/09/2022

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Directions to “ KATHRYN ANDERSON PA” Practice Location

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