Provider Demographics
NPI:1831974930
Name:ANDERSON, ALBERT DELTON JR (AGACNP)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:DELTON
Last Name:ANDERSON
Suffix:JR
Gender:M
Credentials:AGACNP
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Mailing Address - Street 1:2947 CALLA LILLY LN
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-8324
Mailing Address - Country:US
Mailing Address - Phone:252-717-5423
Mailing Address - Fax:
Practice Address - Street 1:115 HEART DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-8982
Practice Address - Country:US
Practice Address - Phone:252-744-4400
Practice Address - Fax:252-744-7623
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5018512363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care