Individual
SELENA ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC, FNP-C
Contact information
Practice address
1700 HOSPITAL SOUTH DR STE 301, AUSTELL, GA 30106-8116
(770) 819-9211
Mailing address
4400 BROWNSVILLE RD STE 105-3620, POWDER SPRINGS, GA 30127-3199
(770) 819-9211
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN198374
GA
363LF0000X
Family Nurse Practitioner
RN198374
GA
363LW0102X
Women's Health Nurse Practitioner
Primary
RN1981374
GA
Other
Enumeration date
04/02/2014
Last updated
04/04/2023
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