Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Anthony Ancrum, RN

Individual provider Registered Nurse · NPI 1306078357

Charles Anthony Ancrum, RN is a Registered Nurse in Covington, Georgia. Licensed in Georgia and New York. Registered with an NPI since 2009.

Licensed in
GA, NY
In the registry since
2009
Specialties on file
5
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

20 Riverstone Dr
Covington, GA 30014-5027
Phone: (404) 510-5027
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 622351 (NY)
Continuing Education/Staff Development Registered Nurse Taxonomy 163WC1600X · Licence 622351-01 (GA)
Critical Care Medicine Registered Nurse Taxonomy 163WC0200X · Licence 622351-01 (GA)
Wound Care Registered Nurse Taxonomy 163WW0000X · Licence 622351-01 (GA)
Administrator Registered Nurse Taxonomy 163WA2000X · Licence 622351-01 (GA)

Record details

NPI number1306078357
Entity typeIndividual (Type 1)
GenderMale
Credentials RN
Sole proprietorNo
NPI enumeratedAugust 10, 2009
Last updated in NPPESSeptember 6, 2025
Certification dateSeptember 6, 2025
Mailing address20 Riverstone Dr, Covington, GA 30014-5027

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