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Individual

CAROLINE ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
278 S MAIN ST, BAXLEY, GA 31513-0102
(912) 367-9559
(912) 367-9554
Mailing address
278 SOUTH MAIN STREET, BAXLEY, GA 31513
(912) 367-9559
(912) 367-9554

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN154703
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
329161117A
GA
Enumeration date
03/02/2009
Last updated
03/25/2010
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