Healthcare Provider Details

I. General information

NPI: 1588308910
Provider Name (Legal Business Name): ANNA SAMS HURLEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. ANNA SAMS GREEN

II. Dates (important events)

Enumeration Date: 04/22/2022
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 GA HIGHWAY 96 STE D3-D5
KATHLEEN GA
31047-2111
US

IV. Provider business mailing address

1114 GA HIGHWAY 96 STE D3-D5
KATHLEEN GA
31047-2111
US

V. Phone/Fax

Practice location:
  • Phone: 478-910-1090
  • Fax:
Mailing address:
  • Phone: 478-910-1090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP294295
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: