MEDICARE: DR. JESSICA KATE ANDERSON N.M.D.

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	175F00000X	Naturopath	05-886	AZ

General Provider Information

NPI Number	:	1992884720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA KATE ANDERSON N.M.D.

Provider Business Mailing Address
First Line	:	14015 N 94TH ST
Second Line	:	APT 3130
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-3723
Country	:	US
Telephone Number	:	480-330-2515
Fax Number	:

Provider Business Practice Location Address
First Line	:	4440 S RURAL RD
Second Line	:	BUILDING F, 2ND FLOOR
City	:	TEMPE
State	:	AZ
Zip	:	85282-7044
Country	:	US
Telephone Number	:	480-883-7240
Fax Number	:

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	07/08/2007

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