Individual
CAROLYNN ANNE DESANDRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, CMN, FNP-BC
Contact information
Practice address
134 ANSLEY DR, SUITE 200, DAHLONEGA, GA 30533-1640
(706) 864-2155
(706) 374-7628
Mailing address
165 BLUE RIDGE OVERLOOK, BLUE RIDGE, GA 30513-4431
(706) 946-5600
(706) 374-7628
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN113863
GA
367A00000X
Advanced Practice Midwife
RN113863
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003133660B
—
GA
Enumeration date
03/28/2007
Last updated
05/30/2017
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