1033285564 NPI number — MS. MARY MARGARET ANDERSEN APRN, CNS, MSN

Table of content: MS. MARY MARGARET ANDERSEN APRN, CNS, MSN (NPI 1033285564)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033285564 NPI number — MS. MARY MARGARET ANDERSEN APRN, CNS, MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDERSEN
Provider First Name:
MARY
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN, CNS, MSN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033285564
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11800 SINGLETREE LN STE 204
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDEN PRAIRIE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55344-5397
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-322-8532
Provider Business Mailing Address Fax Number:
952-322-8513

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11800 SINGLETREE LN
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
EDEN PRAIRIE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55344-5328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
952-322-8532
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 364SP0807X , with the licence number:  R119098 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 364SP0808X , with the licence number: R119098 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 364SP0809X , with the licence number: R119098 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 364S00000X , with the licence number: 79 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 33G27AN . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 41-2001259 . This is a "SELECT CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 62-51410 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 990991009372 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 12291815 . This is a "VALUEPOINT (MULTIPLAN)" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 77745 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 588755100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 150212 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 457962 . This is a "VALUE OPTIONS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 0411805759 . This is a "FORTIS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1134583 . This is a "ARAZ" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com