Anderson, Judi L

Anderson, Judi L is an individual health care provider with primary practice located at 512 Main Ave , Lake Norden SD 57248-0079. 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, Judi L can be contacted via phone (605) 785-3633.

Contact Information

Primary practice address
512 Main Ave Lake Norden SD 57248-0079
Fax: (605) 785-3946
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R031664 South Dakota

Profile Details

NPI number 1801875265
LBN Legal business name Anderson, Judi L
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 13th, 2006
Last updated May 8th, 2008 - about 16 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 1801875265 NPPES
South Dakota MEDICAID 5300462

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