Courtney Aline Anderson, RN

Individual provider Active NPI Registered Nurse · Hannibal, MO

NPI 1285397018 · NPPES record last updated Oct 19, 2021

Key facts

NPI
1285397018
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
13-125069-031 (KS)
Practice address
653 Clinic Rd
Hannibal, MO 63401-3607
Phone
(573) 629-2001
Fax
(573) 629-2008
NPI assigned
Oct 19, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
13-125069-031KSMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 13-125069-031 KS Yes

Addresses

Primary practice location

653 Clinic Rd
Hannibal, MO 63401-3607

Mailing address

921 S Montclaire Dr
Olathe, KS 66061-4122

Other providers in Hannibal, MO

All providers in Hannibal, MO · Registered Nurse in Missouri

Sources for this page

Verify at the official NPI Registry.