Individual
TAMMI L CANTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
966 BROCK RD, FORT VALLEY, GA 31030-5232
(478) 697-0899
Mailing address
966 BROCK RD, FORT VALLEY, GA 31030-5232
(478) 697-0899
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN172049
GA
Other
Enumeration date
06/06/2025
Last updated
06/06/2025
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