Individual
DESTINY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
2461 BEAR MOUNTAIN ST, LITHONIA, GA 30058-8832
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN298289
GA
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
RN298289
GA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN298289
GA
Other
Enumeration date
12/07/2024
Last updated
12/07/2024
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