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General NPI Number Information
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NPI Number | 1326551599
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Entity Type | Individual
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Provider Name | ALICIA VONCEIA ANDERSON PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 7901 4TH ST N STE 29946
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 770-480-1441
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Fax |
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Provider Business Mailing Address
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Address Line | 409 FIRST DR
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City | LADY LAKE
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State | FL
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Zip | 32159-4627
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Country | US
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Telephone | 470-642-0723
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9596408
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN260500
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11043254
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License Number State | FL
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