Doctor Name: | WILLETA JONELL ANDERSON |
NPI Number: | 1043461361 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPN,MHPP |
License Number: | L38013 |
Business Practice Address: | 106 W 3rd St Imboden, AR - 724349114 |
Business Phone Number: | 8708691500 |
Business Fax Number: | 8708691505 |
Mailing Address: | 106 W 3rd St, IMBODEN |
State: | AR |
Postal Code: | 724349114 |
Phone Number: | 8708691500 |
Fax Number: | 8708691505 |
NPI Enumeration Date: | 10/06/2008 |
NPI Last Update Date: | 10/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | L38013 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AR |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |