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Individual

MRS. MICHELLE ANNMARIE ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
115 BLACKTOP DR, FAIRBURN, GA 30213-4442
(770) 969-1125
Mailing address
115 BLACKTOP DR, FAIRBURN, GA 30213-4442
(404) 421-0542

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN165519
GA
163WH0200X
Home Health Registered Nurse
RN165519
GA
363LF0000X
Family Nurse Practitioner
NP165519
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
336085
AZ

Other

Enumeration date
02/11/2009
Last updated
04/24/2026
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