Provider Demographics
NPI:1619745957
Name:ANDERSON, TEMPERANCE ANDREA (NP)
Entity Type:Individual
Prefix:
First Name:TEMPERANCE
Middle Name:ANDREA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 LANWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-6002
Mailing Address - Country:US
Mailing Address - Phone:256-830-9600
Mailing Address - Fax:
Practice Address - Street 1:475 PROVIDENCE MAIN ST NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-4815
Practice Address - Country:US
Practice Address - Phone:256-830-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-135559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily