Provider Demographics
NPI:1366826406
Name:ANDERSON, PAULA (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:FNP-BC
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 338
Mailing Address - Street 2:
Mailing Address - City:ALBERTA
Mailing Address - State:VA
Mailing Address - Zip Code:23821-0338
Mailing Address - Country:US
Mailing Address - Phone:434-949-7211
Mailing Address - Fax:434-949-7134
Practice Address - Street 1:8380 BOYDTON PLANK ROAD
Practice Address - Street 2:
Practice Address - City:ALBERTA
Practice Address - State:VA
Practice Address - Zip Code:23821-0338
Practice Address - Country:US
Practice Address - Phone:434-949-7211
Practice Address - Fax:434-949-7134
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily