MEDICARE: ANNA ELIZABETH HURLEBAUS RN, MS., CS

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	RN081291	GA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN081291	GA

General Provider Information

NPI Number	:	1205862430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA ELIZABETH HURLEBAUS RN, MS., CS

Provider Business Mailing Address
First Line	:	2688 GOODFELLOWS RD
Second Line	:
City	:	TUCKER
State	:	GA
Zip	:	30084-2702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3355 LENOX ROAD NE SUITE 1000
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326
Country	:	US
Telephone Number	:	404-788-2320
Fax Number	:

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	01/06/2025

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