NPI 1245742337 · live from the CMS NPI Registry
Brady Wendell Anderson, PA
Physician Assistant in Jamestown, ND. National Provider Identifier 1245742337, active.
NPI record
| NPI | 1245742337 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 300 2nd Ave Ne, Jamestown, ND 58401 |
| Practice phone | 701-251-6000 |
| Mailing address | 2201 N Ursula St Apt 6-327, Aurora, CO 80045 |
| Enumerated | October 29, 2017 |
| Last updated | June 19, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Surgical | 363AS0400X | — |
| Physician Assistant primary | 363A00000X | PAC0710 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.