Individual
AUGUSTA LEANA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3120 SOUTHRIDE LN, BONIFAY, FL 32425-3325
(850) 547-4440
(850) 547-4441
Mailing address
3120 SOUTHRIDE LN, BONIFAY, FL 32425-3325
(850) 547-4440
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9459929
FL
363LF0000X
Family Nurse Practitioner
Primary
11015260
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN11015260
DOH
FL
Enumeration date
04/06/2020
Last updated
09/24/2021
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