Alicia Anderson, APRN

Individual provider Active NPI Family Nurse Practitioner · Mount Washington, KY

NPI 1639748569 · NPPES record last updated Feb 17, 2025

Key facts

NPI
1639748569
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
3016296 (KY)
Practice address
138 Eastbrooke CT Unit 115
Mount Washington, KY 40047-5570
Phone
(502) 617-4068
NPI assigned
Jun 24, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3016296KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mt Washington Pediatrics PLLC Family Current
since Feb 23, 2025
Accepting new patients

Locations

138 Eastbrooke Ct
Unit 115
Mount Washington, KY 40047
Phone (502) 617-4068

231 Midland Park
Shelbyville, KY 40065
Phone (502) 633-6040

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEABED/Endpoint/EEABED
  • Direct secure messaging: alicia.anderson.1@30410.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3016296 KY Yes

Addresses

Primary practice location

138 Eastbrooke CT Unit 115
Mount Washington, KY 40047-5570

Mailing address

138 Eastbrooke CT Unit 115
Mount Washington, KY 40047-5570
Phone (502) 617-4068

Other identifiers

IdentifierTypeStateIssuer
7100961760MedicaidKY
1013784982OtherNPI

Other providers in Mount Washington, KY

All providers in Mount Washington, KY · Family Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.