Provider Demographics
NPI:1295954055
Name:ANDERSON, ANN REID (NP)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:REID
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 1:2317 SCARSBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-2701
Mailing Address - Country:US
Mailing Address - Phone:804-560-9545
Mailing Address - Fax:
Practice Address - Street 1:1300 W BROAD ST
Practice Address - Street 2:SUITE 2200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23284-9089
Practice Address - Country:US
Practice Address - Phone:804-828-8828
Practice Address - Fax:804-828-6688
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001062322363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner