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NPI Code Detail

MEDICARE: MATTHEW STEVEN ANDERSON RN

MEDICARE:   MATTHEW STEVEN ANDERSON  RN
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
1103TP0016XPrescribing (Medical) Psychologist

General Provider Information

NPI Number : 1992685432
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW STEVEN ANDERSON RN
Provider Business Mailing Address
First Line : 456 MOHICAN LN
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-8317
Country : US
Telephone Number : 318-294-7382
Fax Number :
Provider Business Practice Location Address
First Line : 456 MOHICAN LN
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-8317
Country : US
Telephone Number : 318-294-7382
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2025
Last Update Date : 09/04/2025

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Directions to “ MATTHEW STEVEN ANDERSON RN” Practice Location

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