Anderson, Garrett B
Anderson, Garrett B is an individual health care provider with primary practice located at 2801 W Kinnickinnic River Pkwy Ste 370 , Milwaukee WI 53215-3678. 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, Garrett B can be contacted via phone (414) 649-7900.Contact Information
Primary practice address
2801 W Kinnickinnic River Pkwy Ste 370
Milwaukee WI 53215-3678
Phone: (414) 649-7900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 4816-023 | Wisconsin |
Profile Details
| NPI number | 1366097420 |
|---|---|
| LBN Legal business name | Anderson, Garrett B |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 6th, 2019 |
| Last updated | Nov 19th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366097420 | NPPES |
| Wisconsin | MEDICAID | 100092798 |
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