MEDICARE: ADRIENNE 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	363AM0700X	Medical Physician Assistant	8289	GA

General Provider Information

NPI Number	:	1841738044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIENNE ANDERSON

Provider Business Mailing Address
First Line	:	1800 HOWELL MILL RD NW STE 450
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2508
Country	:	US
Telephone Number	:	404-355-4393
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 HOWELL MILL RD NW STE 450
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2508
Country	:	US
Telephone Number	:	404-355-4393
Fax Number	:	404-214-3053

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

Provider Enumeration Date	:	02/08/2017
Last Update Date	:	04/15/2020

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Directions to “ ADRIENNE ANDERSON ” Practice Location

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