| Doctor Name: | JEANNINE SUSAN ANDERSON |
| NPI Number: | 1003881996 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 1346573022 |
| Business Practice Address: | 2808 E Central Wichita, KS - 67214 |
| Business Phone Number: | 3164404060 |
| Business Fax Number: | 3164404058 |
| Mailing Address: | 2808 E Central, WICHITA |
| State: | KS |
| Postal Code: | 67214 |
| Phone Number: | 3164404060 |
| Fax Number: | 3164404058 |
| NPI Enumeration Date: | 02/22/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 1346573022 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | KS |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |