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NPI Code Detail

MEDICARE: JASMYN LYNNEE ANDERSON

MEDICARE:   JASMYN LYNNEE ANDERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376K00000XNurse's AideCN0014201764GA

General Provider Information

NPI Number : 1366931198
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMYN LYNNEE ANDERSON
Provider Business Mailing Address
First Line : 1045 CRYSTAL WATER DR
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30045-8635
Country : US
Telephone Number : 470-207-4280
Fax Number :
Provider Business Practice Location Address
First Line : 1045 CRYSTAL WATER DR
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30045-8635
Country : US
Telephone Number : 470-207-4280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2018
Last Update Date : 05/07/2018

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Directions to “ JASMYN LYNNEE ANDERSON ” Practice Location

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