Anderson, Dora

Anderson, Dora is an individual health care provider with primary practice located at 3502 W Northside Dr , Jackson MS 39213-4454. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Anderson, Dora can be contacted via phone (601) 362-5321.

Contact Information

Primary practice address
3502 W Northside Dr Jackson MS 39213-4454
Phone: (601) 362-5321
Fax: (601) 362-5321
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R701564 Mississippi

Profile Details

NPI number 1932142502
LBN Legal business name Anderson, Dora
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Jul 9th, 2007 - about 18 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 1932142502 NPPES
Mississippi MEDICAID 00120569

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