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GEORGIA ELIZABETH TANNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
180 KIMEL PARK DR, WINSTON SALEM, NC 27103-6976
(336) 765-2523
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-2000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07363
NC

Other

Enumeration date
05/24/2017
Last updated
09/13/2023
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