MEDICARE: KATHERINE ANDERSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	343900000X	Non-emergency Medical Transport (VAN)
2	347C00000X	Private Vehicle
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1982360160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE ANDERSON

Provider Business Mailing Address
First Line	:	26817 LAKEVUE DR APT 14
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-3318
Country	:	US
Telephone Number	:	813-580-6321
Fax Number	:

Provider Business Practice Location Address
First Line	:	26817 LAKEVUE DR APT 14
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-3318
Country	:	US
Telephone Number	:	813-580-6321
Fax Number	:

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

Provider Enumeration Date	:	11/12/2021
Last Update Date	:	11/12/2021

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Directions to “ KATHERINE ANDERSON ” Practice Location

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