Doctor Name: | VALERIE ANDERSON |
NPI Number: | 1124498365 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DNP |
License Number: | 209013385 |
Business Practice Address: | 100 S Main St West Salem, IL - 624761202 |
Business Phone Number: | 6184563727 |
Business Fax Number: | |
Mailing Address: | 800 E Locust St, OLNEY |
State: | IL |
Postal Code: | 624502553 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/30/2015 |
NPI Last Update Date: | 09/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 209013385 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |