Amy L Anderson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

27115-031 Issued in WI

Practice address

614 Baxter St
Marinette, WI 54143-2906

Phone

(715) 732-4643

NPI assigned

Jul 14, 2010

Last updated

Jul 14, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1164735536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 BAXTER ST",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541432906",
            "telephone_number": "715-732-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 BAXTER ST",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541432906",
            "telephone_number": "715-732-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-14",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "27115-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Physical Therapy & Sports Medicine SC
• Thea J Aguon, OT
• Siddhanth Ahluwalia, MD
• Emmanouil Alimpertis, M.D.
• American Lutheran Church-Northland Luthern Services for the Elderly, I (Luther Home)
• Carrie Anderson, RN
• Hayward Anderson, R.PH.
• Lisa Anderson
• Susan E Arcaro, DO
• Jesse A Ard, SAC

• Licensed Practical Nurse in Marinette, WI
• Providers in Marinette, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.