Individual
TABATHA PESHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
148 BILL CARRUTH PKWY, SUITE 100, HIRAM, GA 30141-3754
(678) 324-4444
(770) 528-9932
Mailing address
60 CHASTAIN CENTER BLVD NW STE 66, KENNESAW, GA 30144-5598
(770) 423-0595
(678) 391-5055
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
115803
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115511749C
—
GA
05
—
115511749D
—
GA
05
—
115511749E
—
GA
05
—
115511749F
—
GA
05
—
115511749G
—
GA
Enumeration date
01/15/2007
Last updated
09/19/2025
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