Provider Demographics
NPI:1861951527
Name:ANDERSON, AMY LYNN (FNP-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58378
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8378
Mailing Address - Country:US
Mailing Address - Phone:281-816-3091
Mailing Address - Fax:832-905-3942
Practice Address - Street 1:600 N KOBAYASHI STE 212
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4841
Practice Address - Country:US
Practice Address - Phone:281-816-3091
Practice Address - Fax:832-905-3942
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX790971363LF0000X
TXAP141596363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily