Individual
TISHARIE SYDAR NEEDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1412 MILSTEAD AVE NE, CONYERS, GA 30012-3877
(404) 605-2800
Mailing address
5665 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1764
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN234785
GA
363L00000X
Nurse Practitioner
Primary
APRN-NP234785
GA
363L00000X
Nurse Practitioner
Primary
RN234785
GA
Other
Enumeration date
06/19/2021
Last updated
03/17/2026
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