Provider Demographics
NPI:1194383562
Name:ANDERS, CHRISTINE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:ANDERS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 E HORSESHOE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-4267
Mailing Address - Country:US
Mailing Address - Phone:480-677-4620
Mailing Address - Fax:
Practice Address - Street 1:139 E HORSESHOE DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-4267
Practice Address - Country:US
Practice Address - Phone:480-677-4620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ226643363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner