Basic Information
Provider Information
NPI: 1447589122
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANDERSON
FirstName: FRANCES
MiddleName: NICOLE
NamePrefix: MRS.
NameSuffix:  
Credential: MS, OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 116 TOPEKA LN
Address2:  
City: COXS CREEK
State: KY
PostalCode: 400137824
CountryCode: US
TelephoneNumber: 2705359664
FaxNumber:  
Practice Location
Address1: 875 PENNSYLVANIA AVE
Address2: SUITE A
City: BARDSTOWN
State: KY
PostalCode: 400042529
CountryCode: US
TelephoneNumber: 5023496961
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/09/2009
LastUpdateDate: 12/09/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XKY-R4280KYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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