Carrie Lee Anderson, ATC
Individual provider Active NPI Athletic Trainer · Terre Haute, IN
NPI 1497908776 · NPPES record last updated Jan 13, 2012
Key facts
- NPI
- 1497908776
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 36001697A (IN)
- Practice address
- 567 N 5TH St
Terre Haute, IN 47809-1903 - Phone
- (217) 369-2216
- NPI assigned
- Oct 30, 2008
- 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 |
|---|---|---|---|
| 096-002620 | IL | MD | Athletic Trainer |
| 36001697A | IN | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096-002620 | IL | |
| Athletic Trainer | 2255A2300X | 36001697A | IN | Yes |
Addresses
Primary practice location
567 N 5TH St
Terre Haute, IN 47809-1903
Mailing address
12304 N 1900TH St
Marshall, IL 62441-4805
Other providers in Terre Haute, IN
- Anderson Chiropractic of Terre Haute, Inc
- Anderson Management Services, Inc
- Amanda Leigh Anderson
- Bart A Anderson
- Candy Anderson
- Casey Anderson
- Kevin D Anderson
- Kriston K. Anderson
- Olivia Anderson
- Pamela Anderson
All providers in Terre Haute, IN · Athletic Trainer in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2012. 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.