Individual
DIANE ANSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2605 PARKWOOD DR, BRUNSWICK, GA 31520-4726
(912) 554-3559
(912) 466-8995
Mailing address
POST OFFICE BOX 1213, BRUNSWICK, GA 31521-1213
(912) 466-5000
(912) 466-5013
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN046318
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000714315A
—
GA
Enumeration date
11/08/2005
Last updated
08/19/2014
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