Individual
KRISTIN SUE ANDERSON-TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
411 ORCHARD HILL RD, SUMMERVILLE, GA 30747-6548
(706) 978-9991
Mailing address
411 ORCHARD HILL RD, SUMMERVILLE, GA 30747-6548
(706) 978-9991
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
022313
NY
363AM0700X
Medical Physician Assistant
5601002268
MI
363AM0700X
Medical Physician Assistant
Primary
6019
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396805529
—
GA
05
—
1396805529
—
NY
Enumeration date
12/11/2006
Last updated
09/13/2018
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