Individual
DEREK MILES ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
1120 INDIAN DR, EASTMAN, GA 31023-7670
(678) 858-8503
Mailing address
505 WHITTINGTON WAY, PEACHTREE CITY, GA 30269-3800
(678) 858-8503
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP128292
GA
363L00000X
Nurse Practitioner
Primary
RN128292
GA
Other
Enumeration date
08/11/2020
Last updated
02/04/2026
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