Provider Demographics
NPI:1538260781
Name:ANDERSON, MAUREEN F (ARNP)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:F
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:305 NW ENGLEWOOD COURT
Mailing Address - Street 2:SUITE #300
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4072
Mailing Address - Country:US
Mailing Address - Phone:816-453-7473
Mailing Address - Fax:816-453-1940
Practice Address - Street 1:305 NW ENGLEWOOD COURT
Practice Address - Street 2:SUITE #300
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-4072
Practice Address - Country:US
Practice Address - Phone:816-453-7473
Practice Address - Fax:816-453-1940
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2013-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO142568363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOI32E25Medicare ID - Type Unspecified
MOQ56994Medicare UPIN