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Individual

CASEY TANNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
5461 MERIDIAN MARK RD STE 570, ATLANTA, GA 30342-2807
(404) 785-6895
(404) 785-6896
Mailing address
5461 MERIDIAN MARK RD STE 570, ATLANTA, GA 30342-2807
(404) 785-6895
(404) 785-6896

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN220734
GA

Other

Enumeration date
02/17/2022
Last updated
02/17/2022
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