| Doctor Name: | JOEL JUSTIN ANDERSON |
| NPI Number: | 1043668817 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSN, NP-C |
| License Number: | CNP 4539 |
| Business Practice Address: | 29399 Rostad Loop Underwood, MN - 565869262 |
| Business Phone Number: | 3208411536 |
| Business Fax Number: | |
| Mailing Address: | 29399 Rostad Loop, UNDERWOOD |
| State: | MN |
| Postal Code: | 565869262 |
| Phone Number: | 3208411536 |
| Fax Number: | |
| NPI Enumeration Date: | 06/01/2016 |
| NPI Last Update Date: | 06/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | CNP 4539 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |