Doctor Name: | MISTY DAWN ANDERSON |
NPI Number: | 1750550026 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, APN |
License Number: | APN13264 |
Business Practice Address: | 4330 Maynardville Hwy Maynardville, TN - 378073618 |
Business Phone Number: | 8659923849 |
Business Fax Number: | 8659925166 |
Mailing Address: | Department 888182, KNOXVILLE |
State: | TN |
Postal Code: | 379958182 |
Phone Number: | 8003553565 |
Fax Number: | 4237142355 |
NPI Enumeration Date: | 02/21/2008 |
NPI Last Update Date: | 02/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | APN13264 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |