Individual provider · Type 1 NPI
Stacie Anderson, AGNP
Gerontology Nurse Practitioner · Sonoma, CA
NPI number
1407695182
Active
Practice location
19270 Sonoma Highway
Sonoma, CA 95476
Mailing address
911 Lakeville St # 116
Petaluma, CA 94952-3329
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 95029378 (CA) |
| Primary Care Nurse Practitioner | 363LP2300X | 95029378 (CA) |
| Gerontology Nurse Practitioner Primary | 363LG0600X | 95029378 (CA) |
Gerontology Nurse Practitioner: Definition to come...
3 other providers at this address
About NPI 1407695182
Stacie Anderson, AGNP's National Provider Identifier is 1407695182, issued on May 22, 2024. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Sonoma, CA. The record was last updated on May 22, 2024.