Individual
MRS. TANISHA BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
605 STEDMAN CIR, MCDONOUGH, GA 30253-5947
(404) 910-8785
Mailing address
100 POSTMASTER DR UNIT 3121, MCDONOUGH, GA 30253-2829
(404) 910-8785
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN286190
GA
Other
Enumeration date
06/01/2020
Last updated
06/01/2020
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