Kristine Ellen Anderson, APRN-CNP
Individual provider Active NPI Pediatric Nurse Practitioner · Marble Falls, TX
NPI 1245912427 · NPPES record last updated Feb 14, 2024
Key facts
- NPI
- 1245912427
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 1129704 (TX)
- Practice address
- 706 Avenue G
Marble Falls, TX 78654-5866 - Phone
- (830) 201-8900
- NPI assigned
- Aug 7, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231214000653 | TX | Practitioner - Nurse Practitioner | 1557710605 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1129704 | TX | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott & White Hospital - Marble Falls | Pediatrics | Current |
Accepting new patients |
| Scott & White Hospital - Marble Falls | Current |
Accepting new patients |
Locations
102 E Young St
Llano, TX 78643
Phone (325) 247-3138
810 W Highway 71
Marble Falls, TX 78654
Phone (830) 201-7100
706 Avenue G
Marble Falls, TX 78654
Phone (830) 201-8900
2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100
Interoperability endpoints
- kanderson618067@direct.sw.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1129704 | TX | |
| Pediatric Nurse Practitioner | 363LP0200X | 1129704 | TX | Yes |
Addresses
Primary practice location
706 Avenue G
Marble Falls, TX 78654-5866
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kanderson618067@direct.sw.org | Direct |
Other providers in Marble Falls, TX
- Ray Garcia Alba
- Victoria M Ambrus
- Amy L. Offutt, M.D., P.a.
- Amy Van Dorfy M D P a
- Janet Ann Anderson
- Lori Renee Anderson
- Michael Zachery Angelillis
- Robert R Anthony
- Apex Hospice LLC
- Glenn Charles Armen
All providers in Marble Falls, TX · Pediatric Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.