Michele Marie Anderson
Individual provider Active NPI Licensed Practical Nurse · Canastota, NY
NPI 1013220664 · NPPES record last updated Jul 23, 2010
Key facts
- NPI
- 1013220664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 231025 (NY)
- Practice address
- 208 Ravine St
Canastota, NY 13032-1544 - Phone
- (315) 697-9630
- NPI assigned
- Jul 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 231025 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 231025 | NY | Yes |
Addresses
Primary practice location
208 Ravine St
Canastota, NY 13032-1544
Mailing address
208 Ravine St
Canastota, NY 13032-1544
Other providers in Canastota, NY
- Doris Marie Ackerman
- Alfred M. Russitano
- Barbara J Vaccaro
- Danielle Marie Birckhead
- Michele L Broniszewski
- Kathleen Sullivan Buda
- Canastota Central School
All providers in Canastota, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.