Provider Demographics
NPI:1285930024
Name:TANT, ERIN MOLLY (RN, ANP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MOLLY
Last Name:TANT
Suffix:
Gender:F
Credentials:RN, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 N 5TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-2706
Mailing Address - Country:US
Mailing Address - Phone:706-295-5150
Mailing Address - Fax:706-295-4865
Practice Address - Street 1:909 N 5TH AVE NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2706
Practice Address - Country:US
Practice Address - Phone:706-295-5150
Practice Address - Fax:706-295-4865
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN186677363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health