Katherine Ann Anderson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

77094 Issued in ID

Practice address

73 Navajo Dr
Pocatello, ID 83202

Phone

(208) 478-3987

NPI assigned

Jul 31, 2023

Last updated

Jan 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1629759667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3773 N FLINT AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834016370",
            "telephone_number": "208-521-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 NAVAJO DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83202",
            "telephone_number": "208-478-3987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3767 Professional Way",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834027315",
            "country_code": "US",
            "telephone_number": "208-785-2003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "77094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garret Anderson
• Gary Steven Anderson
• Isabella Raquel Anderson, LPC
• Jordan Scott Anderson, DPT
• Kallee Anderson, LMFT
• Matthew Anderson, PA
• Michael A Anderson, DO
• Morgan Newel Anderson, D.O.
• Natalie Anderson
• Rylan Anderson, DO

• Family Nurse Practitioner in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.