Provider Demographics
NPI:1609217769
Name:ANDERSON, RITA ANN (NP)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:ANN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:3366 OAKDALE AVE N
Mailing Address - Street 2:SUITE 551
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2948
Mailing Address - Country:US
Mailing Address - Phone:763-587-7737
Mailing Address - Fax:763-587-7069
Practice Address - Street 1:3366 OAKDALE AVE N
Practice Address - Street 2:SUITE 551
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2948
Practice Address - Country:US
Practice Address - Phone:763-587-7737
Practice Address - Fax:763-587-7069
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNAG0613043363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology