Healthcare Provider Details

I. General information

NPI: 1467976811
Provider Name (Legal Business Name): TALIA MONTOYA ANDERSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TALIA MONTOYA ANDERSON RN

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 N HANSELL ST
THOMASVILLE GA
31792-4542
US

IV. Provider business mailing address

927 N HANSELL ST
THOMASVILLE GA
31792-4542
US

V. Phone/Fax

Practice location:
  • Phone: 229-289-2258
  • Fax: 229-213-5071
Mailing address:
  • Phone: 229-289-2258
  • Fax: 229-213-5071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN257947
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: