Provider Demographics
NPI:1568858405
Name:ANDERSON, JOYCE (FNP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2046 ALF HARRIS RD
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:TN
Mailing Address - Zip Code:38477-6307
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2046 ALF HARRIS RD
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:TN
Practice Address - Zip Code:38477-6307
Practice Address - Country:US
Practice Address - Phone:931-424-6761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-10709363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily