Desandre, Carolynn Anne

Desandre, Carolynn Anne is an individual health care provider with primary practice located at 134 Ansley Dr Suite 200, Dahlonega GA 30533-1640. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Desandre, Carolynn Anne can be contacted via phone (706) 864-2155.

Contact Information

Primary practice address
134 Ansley Dr Suite 200 Dahlonega GA 30533-1640
Phone: (706) 864-2155
Fax: (706) 374-7628
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X RN113863 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN113863 Georgia

Profile Details

NPI number 1780703306
LBN Legal business name Desandre, Carolynn Anne
Credentials PHD, CMN, FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2007
Last updated May 30th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780703306 NPPES
Georgia MEDICAID 003133660B

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