Individual
MRS. TANISHA ANTEKA OCONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(301) 537-4234
Mailing address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(301) 537-4234
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP119158 / RN 735173
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348033701
—
TX
Enumeration date
10/05/2010
Last updated
06/23/2021
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