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JESSICA J ANDERSON, AGACNP-BC – NPI #1356940118
Gerontology

NPI Profile for JESSICA J ANDERSON in EVANSVILLE, IN.

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Contact Information

JESSICA J ANDERSON, AGACNP-BC
520 MARY ST STE 520
EVANSVILLE, IN  47710-1682
 Phone: 812-424-8231
 Fax: 812-435-8794
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Gerontology

 363LG0600X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for JESSICA J ANDERSON · (Female)

NPI Number 1356940118
Status Active
Credentials AGACNP-BC (Adult-Gerontology Acute Care Nurse Practitioner)
Entity Individual
Enumeration date 10/22/2020
Last updated 02/08/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 71010855
  • IN Medicaid 30048075
  • KY Medicaid 7100725430
  • Other 000001513579 BCBS
  • IN Other 2020093423 BOARD CERT
  • IN Other 71010855 INDIANA STATE LICENSE
Hospital affiliation(s)
  • DEACONESS HOSPITAL INC - (Acute Care)
    600 MARY ST
    EVANSVILLE, IN 47747
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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