Individual
JUDITH LAUREN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(404) 367-3014
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN-NP201550
GA
363LA2100X
Acute Care Nurse Practitioner
RN2012550
GA
363LA2100X
Acute Care Nurse Practitioner
RN201550
GA
363LF0000X
Family Nurse Practitioner
RN201550
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003182231A
PEACH STATE
GA
05
—
003182231A
—
GA
01
—
003182231B
PEACH STATE
GA
05
—
003182231B
—
GA
01
—
04229901
AMERIGROUP
GA
01
—
1304001
WELLCARE
GA
Enumeration date
10/04/2016
Last updated
03/10/2026
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