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General NPI Number Information
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NPI Number | 1275247405
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Entity Type | Individual
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Provider Name | HEATHER ANTHONY NP
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Gender | Female
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Dates
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Enumeration Date | 01/11/2023
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 4153B FLAT SHOALS PKWY STE 200
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City | DECATUR
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State | GA
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Zip | 30034-4189
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Country | US
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Telephone | 404-585-5049
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Fax | 404-591-0292
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Provider Business Mailing Address
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Address Line | PO BOX 1901
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City | LITHONIA
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State | GA
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Zip | 30058-1029
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Country | US
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Telephone | 270-933-0020
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Fax |
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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 | RN277850
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License Number State | GA
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