SALETA ANICA BROGDON


Address: 10 Muirfield Dr, Covington, GA 30016-6536
Phone: 4046416237

SALETA ANICA BROGDON (NPI# 1588277867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588277867
Entity Type Individual
Full Name SALETA ANICA BROGDON
Credential ARNP
Practice Address 10 Muirfield Dr
Covington
GA 30016-6536
Practice Telephone 4046416237
Practice Fax Number 6788064803
Mailing Telephone 4046416237
Mailing Fax Number 6788064803
Enumeration Date 2020-08-26
Last Update Date 2020-08-26
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
RN197303 GA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 10 MUIRFIELD DR
City COVINGTON
State GA
Zip Code 30016-6536

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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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Competitor

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City COVINGTON
Zip Code 30016

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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