Provider Demographics
NPI:1285855643
Name:ANDERSON, MARY ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:TORRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2057 ZOLLINGER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-1927
Mailing Address - Country:US
Mailing Address - Phone:614-209-6538
Mailing Address - Fax:614-487-0747
Practice Address - Street 1:2057 ZOLLINGER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-1927
Practice Address - Country:US
Practice Address - Phone:614-209-6538
Practice Address - Fax:614-487-0747
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH190964163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management