Sakeena Irene Anderson, NP
Individual provider Active NPI Adult Health Nurse Practitioner · Holly Springs, GA
NPI 1770151276 · NPPES record last updated Jun 12, 2021
Key facts
- NPI
- 1770151276
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- RN178649 (GA)
- Practice address
- 218 Manous Way
Holly Springs, GA 30115-8714 - Phone
- (815) 263-1460
- NPI assigned
- Jun 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211219000013 | GA | Order and Referring Only - Nurse Practitioner | 0941691331 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | RN178649 | GA | Yes |
Addresses
Primary practice location
218 Manous Way
Holly Springs, GA 30115-8714
Mailing address
218 Manous Way
Holly Springs, GA 30115-8714
Phone (815) 263-1460
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | NA | Other | |
| Other URL | NA | Other |
Other providers in Holly Springs, GA
- Geoffrey Paul Aaron
- Oluranti A Aladesanmi
- Ijeoma Cecilia Anyanwu
- Nasir Ali Asghar
- Matthew Kyle Austin
- Holly Megan Barker
- Ashley Michelle Bell
All providers in Holly Springs, GA · Adult Health Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.