Anderson, Corey Lee

Anderson, Corey Lee is an individual health care provider with primary practice located at 7220 S Highway 16 , Rapid City SD 57702-8708. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Anderson, Corey Lee can be contacted via phone (605) 341-1414.

Contact Information

Primary practice address
7220 S Highway 16 Rapid City SD 57702-8708
Phone: (605) 341-1414
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0802 South Dakota

Profile Details

NPI number 1194093161
LBN Legal business name Anderson, Corey Lee
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2011
Last updated Jan 16th, 2020 - about 6 years 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 1194093161 NPPES
South Dakota MEDICAID 2003422

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