MEDICARE: KATHY ANDERSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	CN0030101056	GA

General Provider Information

NPI Number	:	1194689497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY ANDERSON

Provider Business Mailing Address
First Line	:	PO BOX 9323
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31412-9323
Country	:	US
Telephone Number	:	912-480-3475
Fax Number	:

Provider Business Practice Location Address
First Line	:	1697 STILLWOOD DR
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31419-2512
Country	:	US
Telephone Number	:	912-480-3475
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	02/11/2026

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Directions to “ KATHY ANDERSON ” Practice Location

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