Tina Anderson

Individual provider Active NPI Peer Specialist · Bowling Green, KY

NPI 1861884850 · NPPES record last updated Feb 27, 2015

Key facts

NPI
1861884850
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone
(270) 901-5000
Fax
(270) 842-5268
NPI assigned
Feb 27, 2015
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Yes

Addresses

Primary practice location

380 Suwannee Trail St
Bowling Green, KY 42103-7956

Mailing address

380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone (270) 901-5000

Other providers in Bowling Green, KY

All providers in Bowling Green, KY · Peer Specialist in Kentucky

Sources for this page

Verify at the official NPI Registry.