Individual provider · NPI-1

Stacyann Nadine Anderson

Home Health Aide · Orlando, FL

NPI number1063273977
StatusActive
Last updated in NPPESJan 18, 2024

Details

NPI
1063273977
Entity type
Individual (NPI-1)
Name
Stacyann Nadine Anderson
Sex
Female
Sole proprietor
No
Enumeration date
Jan 18, 2024
Certification date
Jan 17, 2024
Last updated
Jan 18, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
374U00000X Home Health Aide––Yes
3747P1801X Technician, Personal Care Attendant––

Practice location

4817 Montauk St
Orlando, FL 32808-2753

Phone 407-230-6402

Mailing address

4817 Montauk St
Orlando, FL 32808-2753

Phone 407-230-6402

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