Healthcare Provider Details

I. General information

NPI: 1679013908
Provider Name (Legal Business Name): BARBARA PATRICIA ANDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA PATRICIA ORANGE FNP

II. Dates (important events)

Enumeration Date: 03/06/2017
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date: 12/06/2025
Reactivation Date: 12/16/2025

III. Provider practice location address

130 BYRD WAY
WARNER ROBINS GA
31088-8937
US

IV. Provider business mailing address

220 WILLIAMS CIR
ELKO GA
31025-2040
US

V. Phone/Fax

Practice location:
  • Phone: 478-922-9136
  • Fax: 478-923-6846
Mailing address:
  • Phone: 478-225-7455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number223551
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: