Kellie Coplin Anderson, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1-083086 Issued in AL

Practice address

401 Lowell Dr SE Ste 5
Huntsville, AL 35801

Phone

(256) 265-1775

Fax

(256) 265-1780

NPI assigned

Jun 26, 2009

Last updated

Nov 20, 2018By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1720216906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2705",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358042705",
            "telephone_number": "256-265-1775",
            "fax_number": "256-265-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 LOWELL DR SE STE 5",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "35801",
            "telephone_number": "256-265-1775",
            "fax_number": "256-265-1780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Sivley Rd SW",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358014421",
            "country_code": "US",
            "telephone_number": "256-265-4984",
            "fax_number": "256-265-4987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KELLIE",
        "middle_name": "COPLIN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-083086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199998",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Elaine Anderson
• Jessica Faith Anderson, PA-C
• Julia Anderson, PT
• Kandess J Anderson, CRNP
• Keith Charles Anderson, DO
• Liza Anderson
• Mark Norman Anderson, PA C
• Rodney Anderson, RPH
• Temperance Andrea Anderson, NP
• Tim Anderson, DO

• Pediatric Nurse Practitioner in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.