Anderson, Diane M

Anderson, Diane M is an individual health care provider with primary practice located at 143 South Gibson Street , Medford WI 54451-1622. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Anderson, Diane M can be contacted via phone (715) 748-2121.

Contact Information

Primary practice address
143 South Gibson Street Medford WI 54451-1622
Phone: (715) 748-2121
Fax: (715) 748-7590
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1505-033 Wisconsin

Profile Details

NPI number 1801875364
LBN Legal business name Anderson, Diane M
Credentials FNPC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2006
Last updated May 15th, 2012 - about 12 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 1801875364 NPPES
Wisconsin MEDICAID 43896800

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