Healthcare Provider Details

I. General information

NPI: 1215729595
Provider Name (Legal Business Name): ANNA PLOTNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 S COBB DR SE
SMYRNA GA
30080-7874
US

IV. Provider business mailing address

109 CALIBRE LAKE PKWY SE
SMYRNA GA
30082-7222
US

V. Phone/Fax

Practice location:
  • Phone: 404-807-6473
  • Fax:
Mailing address:
  • Phone: 404-807-6473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN323786
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: