Individual
TANA M. MACERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
2501 N. PATTERSON STREET, VALDOSTA, GA 31602-1735
(229) 433-1000
(229) 259-4405
Mailing address
PO BOX 0070, VALDOSTA, GA 31603-0070
(229) 433-1000
(229) 259-4405
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN127219NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504617020B
—
GA
Enumeration date
02/05/2007
Last updated
06/01/2015
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