Jordyn B Anderson
Individual provider Active NPI Pharmacist · Sioux City, IA
NPI 1497364475 · NPPES record last updated Jul 27, 2020
Key facts
- NPI
- 1497364475
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 23874 (IA)
- Practice address
- 4500 Sergeant Rd
Sioux City, IA 51106-4705 - Phone
- (712) 274-2949
- Fax
- (712) 274-8072
- NPI assigned
- Jul 27, 2020
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23874 | IA | MD | Pharmacist |
Interoperability endpoints
- janderson167136@uihcdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23874 | IA | Yes |
Addresses
Primary practice location
4500 Sergeant Rd
Sioux City, IA 51106-4705
Mailing address
4724 Birch Way
Sioux City, IA 51106-9528
Phone (712) 899-1691
Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2020. 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.