Provider Demographics
NPI:1164733481
Name:ANDERSON, ALANA (CNM)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1903
Mailing Address - Country:US
Mailing Address - Phone:229-436-7248
Mailing Address - Fax:229-431-1951
Practice Address - Street 1:1001 N MONROE ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1903
Practice Address - Country:US
Practice Address - Phone:229-436-7248
Practice Address - Fax:229-431-1951
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN 146734367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife