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Individual

TISHANA L GARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
2525 CUMBERLAND PKWY SE, ATLANTA, GA 30339-3915
(404) 365-0966
Mailing address
111A BERRY AVE, GREER, SC 29651-1307
(864) 801-2035

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3284
SC
363L00000X
Nurse Practitioner
Primary
NP248013
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3284
LICENSE
SC
Enumeration date
09/09/2008
Last updated
10/23/2025
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