Tammy Green, CPNP
Individual provider Active NPI Nurse Practitioner · Locust Grove, GA
NPI 1609234129 · NPPES record last updated Feb 3, 2016
Key facts
- NPI
- 1609234129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN199156 (GA)
- Practice address
- 5040 Bill Gardner Pkwy
Suite 100
Locust Grove, GA 30248-3757 - Phone
- (678) 583-5437
- Fax
- (678) 583-5484
- NPI assigned
- Jan 29, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN199156 | GA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Locust Grove Pediatrics | Past | Accepting new patients | |
| Quinn Pediatrics, PLLC | Pediatrics | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN199156 | GA | Yes |
| Pediatric Nurse Practitioner | 363LP0200X | RN199156 | GA |
Addresses
Primary practice location
5040 Bill Gardner Pkwy
Suite 100
Locust Grove, GA 30248-3757
Mailing address
1002 Summerlake Way
McDonough, GA 30253-7424
Phone (404) 669-7949
Other providers in Locust Grove, GA
- Georgia Psych Services LLC
- Georgia Wellness Services LLC
- Gerizim Health Solutions LLC.
- Evan Nicole Graham
- Great Value Home LLC
- Judlande Guervil
- Gregory Bernadas Guinoo
- H.E.a.L. Supply
- Savannah Alaine Hagood
- Tera Hall
All providers in Locust Grove, GA · Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.