Provider Demographics
NPI:1063406338
Name:ANDERS, CAROL L (CRNP)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:L
Last Name:ANDERS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Mailing Address - Street 1:1972 DANIEL BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HOME
Mailing Address - State:AL
Mailing Address - Zip Code:36041-4106
Mailing Address - Country:US
Mailing Address - Phone:334-537-4480
Mailing Address - Fax:334-264-7284
Practice Address - Street 1:1801 PINE ST
Practice Address - Street 2:SUITE 204
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-0165
Practice Address - Country:US
Practice Address - Phone:334-263-4277
Practice Address - Fax:334-264-7842
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-075633363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51035106ANDMedicare UPIN