Individual
DR. ALEXIS FORTE'-TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3056 NEW MACLAND RD, POWDER SPRINGS, GA 30127-1737
(678) 340-6010
(678) 881-4111
Mailing address
3056 NEW MACLAND RD, POWDER SPRINGS, GA 30127-1737
(678) 340-6010
(678) 881-4111
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
RN169974
GA
163WS0200X
School Registered Nurse
RN169974
GA
164W00000X
Licensed Practical Nurse
LPN080083
GA
174H00000X
Health Educator
RN169974
GA
246RP1900X
Phlebotomy Technician
Primary
LPN080083
GA
253Z00000X
In Home Supportive Care Agency
RN169974
GA
390200000X
Student in an Organized Health Care Education/Training Program
LPN080083
GA
Other
Enumeration date
07/10/2026
Last updated
07/10/2026
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