Provider Demographics
NPI:1477634772
Name:ANDERSON, JANET ANN (ANP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ANN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 PARK ROAD 4 S
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-5468
Mailing Address - Country:US
Mailing Address - Phone:830-798-4908
Mailing Address - Fax:512-355-4190
Practice Address - Street 1:1706 HWY 1431
Practice Address - Street 2:PLAZA WEST, STE A
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-4954
Practice Address - Country:US
Practice Address - Phone:830-798-4908
Practice Address - Fax:512-755-4190
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX439576363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXNP0173Medicare ID - Type Unspecified
TXS05847Medicare UPIN