Individual
GRACE MADRAZO TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
103 GA HIGHWAY 27 E, AMERICUS, GA 31709-3800
(229) 924-8082
(229) 924-8009
Mailing address
103 GA HIGHWAY 27 E, AMERICUS, GA 31709-3800
(229) 924-8082
(229) 924-8009
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN180141
GA
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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