Provider Demographics
NPI:1093276867
Name:VARNER, MARIANA ANDERSON (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MARIANA
Middle Name:ANDERSON
Last Name:VARNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARIANA
Other - Middle Name:GLENN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1991 COMMODORE CT
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1529
Mailing Address - Country:US
Mailing Address - Phone:864-642-7727
Mailing Address - Fax:
Practice Address - Street 1:3400 OLD MILTON PKWY STE C270
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4414
Practice Address - Country:US
Practice Address - Phone:770-442-1911
Practice Address - Fax:770-442-0306
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA9079363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant