Individual
NANCY A ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1505 NORTHSIDE BLVD, STE 2400, CUMMING, GA 30041-7623
(770) 292-3490
(404) 851-6283
Mailing address
1505 NORTHSIDE BLVD, STE 2400, CUMMING, GA 30041-7623
(770) 292-3490
(404) 851-6283
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
002106
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003119970B
—
GA
05
—
003119970C
—
GA
05
—
003119970D
—
GA
Enumeration date
08/31/2006
Last updated
02/02/2017
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