Lara Anderson, PMHNP
Nurse Practitioner, Psych/Mental Health in New York, NY. Individual provider (NPI-1).
NPI number1649954652
StatusActive
Last updated in NPPESJun 12, 2023
Details
- NPI
- 1649954652
- Entity type
- Individual (NPI-1)
- Name
- Lara Anderson
- Credential
- PMHNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 12, 2023
- Certification date
- Jun 10, 2023
- Last updated
- Jun 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 404962 | NY | Yes |
Practice location
198 E 121st StNew York, NY 10035-3523
Phone 212-801-3300
Mailing address
65 W Broad St Apt 602Rochester, NY 14614-2218
Phone 309-255-9730
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