NPI 1548635261 · live from the CMS NPI Registry
Jessica Viola Anderson, CPNP-PC
Nurse Practitioner, Pediatrics in South Euclid, OH. National Provider Identifier 1548635261, active.
NPI record
| NPI | 1548635261 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 2054 S Green Rd, South Euclid, OH 44121 |
| Practice phone | 216-291-9210 |
| Mailing address | 10360 Music St, Newbury, OH 44065 |
| Enumerated | December 7, 2015 |
| Last updated | September 2, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 18644 (OH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.