Individual
JESSICA TANKSLEY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 535-3611
(770) 535-7092
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 533-4786
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN 175466
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN 175466
GEORGIA LICENSE
GA
Enumeration date
09/08/2015
Last updated
08/17/2023
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