Provider Demographics
NPI:1306389903
Name:ANDERSON, ANAHITA (FNP)
Entity Type:Individual
Prefix:
First Name:ANAHITA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANAHITA
Other - Middle Name:
Other - Last Name:MESHKANI-MEHDIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:100 CHERRYWOOD PL
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1741
Mailing Address - Country:US
Mailing Address - Phone:731-695-2165
Mailing Address - Fax:731-664-2175
Practice Address - Street 1:9 PHYSICIANS DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2071
Practice Address - Country:US
Practice Address - Phone:731-661-0086
Practice Address - Fax:731-661-0281
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 0000021900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily