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General NPI Number Information
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NPI Number | 1033115142
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Entity Type | Individual
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Provider Name | ANDREA LOGAN BOSSIE MS, RN, CNN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 526 BANKHEAD HWY STE 101
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City | CARROLLTON
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State | GA
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Zip | 30117-2463
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Country | US
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Telephone | 770-962-3642
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Fax | 770-962-3643
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Provider Business Mailing Address
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Address Line | 455 PHILIP BLVD STE 140
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8768
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Country | US
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Telephone | 770-962-3642
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Fax | 770-962-3643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-NP112876
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License Number State | GA
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