Individual provider · NPI-1

Annika M Anderson

Student in an Organized Health Care Education/Training Program · Atlanta, GA

NPI number1912696964
StatusActive
Last updated in NPPESMay 4, 2023

Details

NPI
1912696964
Entity type
Individual (NPI-1)
Name
Annika M Anderson
Sex
Female
Sole proprietor
No
Enumeration date
May 4, 2023
Certification date
May 4, 2023
Last updated
May 4, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes
2255A2300X Specialist/Technologist, Athletic Trainer––

Practice location

720 Westview Dr Sw
Atlanta, GA 30310-1458

Phone 404-756-1959

Mailing address

3450 Roxboro Rd Ne Apt 5113
Atlanta, GA 30326-1699

Phone 309-781-9355

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