Individual
PAUL DUANE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
204 LISA MARIE CT, WARNER ROBINS, GA 31088-2980
(478) 538-0677
Mailing address
204 LISA MARIE CT, WARNER ROBINS, GA 31088-2980
(478) 538-0677
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN239689
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN239689
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163W00000X
NA
GA
Enumeration date
12/05/2020
Last updated
08/24/2023
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