Individual ProviderAnny ParkNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2320 Peachtree Industrial Blvd Ste 101, Duluth, GA 30097-8045(678) 821-5377PECOS EnrollmentBased on the most recent information from CMS, provider Anny Park does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 9:24 AM.Profile DetailsProvider ID1447016795Provider TypeIndividualFull NamePark, AnnyCredentialMSN, APRN, FNP-CGenderFemaleSole ProprietorNoEnumeration Date2/26/2024Last Updated2/18/2026Contact InformationPractice LocationPractice Address2320 Peachtree Industrial Blvd Ste 101, Duluth, GA 30097-8045Phone(678) 821-5377FaxUnlisted FaxMailing LocationMailing Address2320 Peachtree Industrial Blvd Ste 101, Duluth, GA 30097-8045Phone(678) 821-5377FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN-NP290211Georgia