MEDICARE: MS. ELIZABETH PERSEPHONE ANDERSEN FNP-BC

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
1	163W00000X	Registered Nurse	RN228808	GA
2	363LF0000X	Family Nurse Practitioner	2018080794	GA

General Provider Information

NPI Number	:	1457818015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH PERSEPHONE ANDERSEN FNP-BC

Provider Business Mailing Address
First Line	:	1100 JOHNSON FERRY RD
Second Line	:	STE 510
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30342-1743
Country	:	US
Telephone Number	:	404-419-1165
Fax Number	:

Provider Business Practice Location Address
First Line	:	7813 SPIVEY STATION BLVD STE 210
Second Line	:
City	:	LAKE SPIVEY
State	:	GA
Zip	:	30236-2900
Country	:	US
Telephone Number	:	770-507-0070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2019
Last Update Date	:	09/18/2020

Similar Medicare Providers

1740279009 — DR. JAY U PATEL MD
Practice Location Address:

2929 LAKE PARK DR
LAKE SPIVEY, GA
30236-4131

Practice Phone: 773-726-2682
Practice Fax:

1922173723 — SOUTHERN CRESCENT BREAST SPECIALISTS,PC
Practice Location Address:

7823 SPIVEY STATION BLVD , SUITE 200
LAKE SPIVEY, GA
30236-2886

Practice Phone: 770-507-5055
Practice Fax: 770-507-5880

1912357096 — DARLA BALAS N.P.
Practice Location Address:

7813 SPIVEY STATION BLVD , SUITE 210
LAKE SPIVEY, GA
30236-2900

Practice Phone: 770-507-0070
Practice Fax: 770-507-7463

1003327057 — LINDA ANN MORSE
Practice Location Address:

8237 SEVEN OAKS DR
LAKE SPIVEY, GA
30236-4098

Practice Phone: 678-372-1179
Practice Fax:

1720577372 — VERNESA WRIGHT NP
Practice Location Address:

7813 SPIVEY STATION BLVD STE 210
LAKE SPIVEY, GA
30236-2900

Practice Phone: 770-507-0070
Practice Fax: 770-507-7469

1487012480 — LAKE SPIVEY AMBULATORY SURGERY CARE, LLC
Practice Location Address:

7813 SPIVEY STATION BLVD , SUITE 100
JONESBORO, GA
30236-2900

Practice Phone: 770-268-6000
Practice Fax:

Directions to “ MS. ELIZABETH PERSEPHONE ANDERSEN FNP-BC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.