Amber Anderson
Individual provider Active NPI Contractor · Valdosta, GA
NPI 1033701164 · NPPES record last updated Feb 10, 2021
Key facts
- NPI
- 1033701164
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 2103 Gornto Rd
Valdosta, GA 31602-2217 - Phone
- (229) 834-4638
- NPI assigned
- Feb 10, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
2103 Gornto Rd
Valdosta, GA 31602-2217
Mailing address
2103 Gornto Rd
Valdosta, GA 31602-2217
Phone (229) 834-4638
Other providers in Valdosta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.