Tresselyn Douglas Adams, PMHNP-BC

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Rome, GA

NPI 1104051168 · NPPES record last updated Jun 14, 2019

Key facts

NPI
1104051168
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
RN112304 (GA)
Practice address
1345 Redmond Cir NW
Rome, GA 30165-1307
Phone
(910) 742-9243
Fax
(888) 746-1787
NPI assigned
May 20, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN112304GAMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN112304 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN112304 GA Yes

Addresses

Primary practice location

1345 Redmond Cir NW
Rome, GA 30165-1307

Mailing address

PO Box 538622
Atlanta, GA 30353-8622
Phone (910) 742-9243

Other practice location 1

1007 Memorial Dr
Griffin, GA 30223-4445
Phone (770) 467-4715

Other identifiers

IdentifierTypeStateIssuer
F1108140OtherFAMILY NURSE PRATITIONER CERTIFIED

Other providers in Rome, GA

All providers in Rome, GA · Psychiatric/Mental Health Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.