Healthcare Provider Details

I. General information

NPI: 1437531142
Provider Name (Legal Business Name): MRS. ANNA WYNN STURKIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2015
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 NORTHEAST EXPY NE
BROOKHAVEN GA
30329-2480
US

IV. Provider business mailing address

1777 NORTHEAST EXPY NE
BROOKHAVEN GA
30329-2480
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-7878
  • Fax:
Mailing address:
  • Phone: 404-785-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN289394
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN289394
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: