Individual provider · NPI-1

Kisha Tamara Anderson, APN

Nurse Practitioner, Women's Health · Newark, NJ

NPI number1003881103
StatusActive
Last updated in NPPESJul 13, 2011

Details

NPI
1003881103
Entity type
Individual (NPI-1)
Name
Mrs. Kisha Tamara Anderson
Credential
APN
Sex
Female
Sole proprietor
No
Enumeration date
Feb 22, 2006
Last updated
Jul 13, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LW0102X Nurse Practitioner, Women's Health26NN11131200NJYes

Practice location

151 Washington St
Newark, NJ 07102-3026

Phone 973-622-3900 · Fax 973-622-1698

Mailing address

312 Stuyvesant Ave
Newark, NJ 07106-3637

Phone 973-399-5265

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