Individual
TAMALA BOOKER MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
106 E BROAD ST, SAVANNAH, GA 31401-2917
(912) 464-5187
(912) 527-1099
Mailing address
4002 CAMPBELL ST, SAVANNAH, GA 31405-2927
(912) 220-0059
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
127388
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
127388
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000
N/A
GA
Enumeration date
09/05/2019
Last updated
09/16/2024
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