Provider Demographics
NPI:1124157771
Name:ANDERSON, MARIE PIERRE (GNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:PIERRE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PLEASANT STREET
Mailing Address - Street 2:
Mailing Address - City:MERRIMAC
Mailing Address - State:MA
Mailing Address - Zip Code:01860-1945
Mailing Address - Country:US
Mailing Address - Phone:978-346-4534
Mailing Address - Fax:978-346-4534
Practice Address - Street 1:1 MERRIMACK STREET
Practice Address - Street 2:HAVERHILL FAMILY PRACTICE
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830
Practice Address - Country:US
Practice Address - Phone:978-521-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA177501363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
S37913Medicare UPIN
MAANNP0732Medicare ID - Type Unspecified