person
Stephanie Heaton Anderson, PNP,DNP,RNCS
Adult Health Nurse Practitioner in Canton, Georgia
NPI 1609087972

Stephanie Heaton Anderson is an Adult Health Nurse Practitioner based in Canton, GA and is specialized in Adult Health. Stephanie Heaton Anderson practices in Canton, GA and has the professional credentials of PNP,DNP,RNCS. The NPI Number for Stephanie Heaton Anderson is 1609087972 and holds a License No. RN173488 (Georgia).

The current practice location address for Stephanie Heaton Anderson is 391 East Main Street, Canton, GA and can be reached out via phone at 770-720-6963 and via fax at 770-720-6965.

Location: 391 East Main Street, Canton, GA, 30114-2712
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Provider Profile Details
NPI Number
1609087972
Provider Name
Stephanie Heaton Anderson
Credential
PNP,DNP,RNCS
Provider Entity Type
Individual
Gender
Female
Address
391 East Main Street, Canton, GA, 30114-2712
Phone Number
770-720-6963
Fax Number
770-720-6965
Provider Enumeration Date
05/25/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
495715792A 01 GA MEDICAID PROVIDER ID, STEPHANIE H. ANDERSON, PNP, APRN, NPI# 1609087972
629697125A 01 GA MEDICAID PAYOR ID, NORTHSIDE CHILDREN'S PEDIATRICS CTR, NPI# 1396945515
GA 54532 01 GA AUTHORIZED CONTACT REPRESENTATIVE: MICHAEL G. ANDERSON, MD (ATTENDING PHYSICIAN)
institution
Provider Business Practice Location Address Details
Address
391 East Main Street
City
State
Zip
30114-2712
Phone Number
770-720-6963
Fax Number
770-720-6965
person
Provider Business Mailing Address Details
Address
391 East Main Street
City
State
Zip
30114-2712
Phone Number
770-720-6963
Fax Number
770-720-6965
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
RN173488 (Georgia)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
RN173488 (Georgia)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
RN173488 (Georgia)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Women's Health
Taxonomy
License No.
RN173488 (Georgia)
Definition
Definition to come...
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