Anderson, Amanda Jo

Anderson, Amanda Jo is an individual health care provider with primary practice located at 111 17Th Ave E Ste 101 , Alexandria MN 56308-3734. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Anderson, Amanda Jo can be contacted via phone (320) 762-1144.

Contact Information

Primary practice address
111 17Th Ave E Ste 101 Alexandria MN 56308-3734
Phone: (320) 762-1144
Fax: (320) 762-1935
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 10634 Minnesota

Profile Details

NPI number 1245331529
LBN Legal business name Anderson, Amanda Jo
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245331529 NPPES
Minnesota MEDICAID 1245331529

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