| Doctor Name: | MRS. TABATHA P ANDERSON |
| NPI Number: | 1427248731 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN,MSN,FNPC |
| License Number: | RN149791 |
| Business Practice Address: | 590 Historic Hwy 441 N Demorest, GA - 30535 |
| Business Phone Number: | 7067545511 |
| Business Fax Number: | |
| Mailing Address: | 350 Sunny Brook Trl, CLARKESVILLE |
| State: | GA |
| Postal Code: | 305234197 |
| Phone Number: | 7069880584 |
| Fax Number: | |
| NPI Enumeration Date: | 08/01/2007 |
| NPI Last Update Date: | 09/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | RN149791 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |