Healthcare Provider Details

I. General information

NPI: 1487276770
Provider Name (Legal Business Name): HALEIGH ANDERSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3883 CHAMBLEE DUNWOODY RD
ATLANTA GA
30341-1701
US

IV. Provider business mailing address

3883 CHAMBLEE DUNWOODY RD
ATLANTA GA
30341-1701
US

V. Phone/Fax

Practice location:
  • Phone: 678-644-1230
  • Fax:
Mailing address:
  • Phone: 678-644-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN-NP266842
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN266842
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: