NPI 1528683133 · live from the CMS NPI Registry
Jessica Dawn Anderson, CPNP-PC
Nurse Practitioner in Bristol, TN. National Provider Identifier 1528683133, active.
NPI record
| NPI | 1528683133 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 1 Medical Park Blvd, Bristol, TN 37620 |
| Practice phone | 423-844-1121 |
| Mailing address | 200 Corporate Blvd, Lafayette, LA 70508 |
| Enumerated | June 9, 2020 |
| Last updated | June 14, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Emergency | 163WE0003X | 194136 (TN) |
| Nurse Practitioner, Pediatrics | 363LP0200X | 194136 (TN) |
| Nurse Practitioner primary | 363L00000X | 27703 (TN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.