Michelle Anderson, MSN, RN, CPNP-AC

Individual provider Active NPI Pediatric Nurse Practitioner · Boston, MA

NPI 1699288787 · NPPES record last updated Nov 10, 2017

Key facts

NPI
1699288787
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
RN2286142 (MA)
Practice address
333 Longwood Ave Ste 650
Boston, MA 02115-5711
Phone
(617) 355-8202
NPI assigned
Nov 10, 2017
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
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2286142MDMDRegistered Nurse
RN2286142MAMDPediatric Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2286142 MD
Pediatric Nurse Practitioner 363LP0200X RN2286142 MA Yes

Addresses

Primary practice location

333 Longwood Ave Ste 650
Boston, MA 02115-5711

Mailing address

333 Longwood Ave Ste 650
Boston, MA 02115-5711
Phone (617) 355-8202

Other providers in Boston, MA

All providers in Boston, MA · Pediatric Nurse Practitioner in Massachusetts

Sources for this page

Verify at the official NPI Registry.