Anderson, Connie M

Anderson, Connie M is an individual health care provider with primary practice located at 3290 N Wellness Dr Ste 240 , Holland MI 49424-7261. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Allopathic & Osteopathic Physicians / Dermatology. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Anderson, Connie M can be contacted via phone (616) 395-9379.

Contact Information

Primary practice address
3290 N Wellness Dr Ste 240 Holland MI 49424-7261
Phone: (616) 395-9379
Fax: (616) 820-1457
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601002814 Michigan
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 5601002814 Michigan

Profile Details

NPI number 1124012919
LBN Legal business name Anderson, Connie M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated Jul 18th, 2024 - about 4 months ago

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 1124012919 NPPES
Michigan MEDICAID 1941713

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