Ethan Danny Anderson
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Joplin, MO
NPI 1376450825 · NPPES record last updated Aug 27, 2026
Key facts
- NPI
- 1376450825
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 3001 St Johns Blvd
Joplin, MO 64804 - Phone
- (417) 208-0805
- NPI assigned
- Aug 27, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
3001 St Johns Blvd
Joplin, MO 64804
Mailing address
3001 St Johns Blvd
Joplin, MO 64804
Phone (417) 208-0805
Other providers in Joplin, MO
- Sudhakar Ancha
- Alexa N. Anderson
- Bradley William Anderson
- Bruce Robin Anderson
- Charlene M Anderson
- Amanda Andrade
- Christopher R Andrew
- Tamara Leigh Andrew
- Anesthesia Associates of Joplin LLC
- Angela Comstock
All providers in Joplin, MO · Student in an Organized Health Care Education/Training Program in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.