Provider Demographics
NPI:1285104182
Name:GEORGE, TAMUNO (RN)
Entity type:Individual
Prefix:DR
First Name:TAMUNO
Middle Name:
Last Name:GEORGE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:DR
Other - First Name:TAMUNO
Other - Middle Name:
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:249 CROSS CURRENT LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1521
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:249 CROSS CURRENT LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1521
Practice Address - Country:US
Practice Address - Phone:919-395-0142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-04
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0855X
OK123447163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health