Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APN.21109 | SC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN244922 | GA |
NPI | 1003331539 |
---|---|
Provider Name | Anna Denton |
First Address | Evans, GA 30809-7490 |
Second Address | Aiken, SC 29803-6183 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2017 |
Last Update Date | 05/08/2017 |