Doctor Name: | LISA DASHER ANDERSON |
NPI Number: | 1790145258 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | RN220834 |
Business Practice Address: | 1000b North Veterans Boulevard Glennville, GA - 30427 |
Business Phone Number: | 9126544599 |
Business Fax Number: | 9126544610 |
Mailing Address: | 460 Mall Bvld, Ste.b SAVANNAH |
State: | GA |
Postal Code: | 31406 |
Phone Number: | 9126445300 |
Fax Number: | 9126445260 |
NPI Enumeration Date: | 02/26/2016 |
NPI Last Update Date: | 03/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN220834 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |