Provider Demographics
NPI:1598589616
Name:TUTU, ERIC KWESI (NP)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:KWESI
Last Name:TUTU
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 WOODY HILL CIR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-6715
Mailing Address - Country:US
Mailing Address - Phone:908-906-3081
Mailing Address - Fax:
Practice Address - Street 1:911 WOODY HILL CIR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-6715
Practice Address - Country:US
Practice Address - Phone:908-906-3081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN252536363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health