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NPI 1306588611

NPI 1306588611 : ASHLEE RENEA ANDERSON PMHNP : MARIETTA, GA

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General NPI Number Information
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    NPI Number           |    1306588611
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    Entity Type          |    Individual 
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    Provider Name        |    ASHLEE RENEA ANDERSON PMHNP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/08/2022
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    Last Update Date     |    04/17/2025
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Provider Practice Location Address
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    Address Line         |    1758 COUNTY SERVICES PKWY SW 
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    City                 |    MARIETTA
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    State                |    GA
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    Zip                  |    30008-4012
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    Country              |    US
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    Telephone            |    404-301-5870
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1128 E MOWRY DR APT 104 
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    City                 |    HOMESTEAD
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    State                |    FL
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    Zip                  |    33030-8175
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    Country              |    US
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    Telephone            |    786-234-0725
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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        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    APRN11018599
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    License Number State |    FL
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Taxonomy #2
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    GAA-NP001985
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    License Number State |    GA
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