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NPI Code Detail

MEDICARE: MS. JOAN M. ANDERSON FNP

MEDICARE: MS. JOAN M. 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
1363LF0000XFamily Nurse Practitioner58271-030WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982608899
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JOAN M. ANDERSON FNP
Provider Business Mailing Address
First Line : W339S4971 FOX HOLLOW DR
Second Line :
City : DOUSMAN
State : WI
Zip : 53118-9742
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : W180N8085 TOWN HALL RD
Second Line :
City : MENOMONEE FALLS
State : WI
Zip : 53051-3518
Country : US
Telephone Number : 262-257-5000
Fax Number : 262-257-5005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 07/08/2007

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