Individual
TARA SHANNON ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
Mailing address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN175216 NP
GA
Other
Enumeration date
01/10/2012
Last updated
06/28/2022
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