Provider Demographics
NPI:1992108328
Name:DUNN, TAMARIA (FNP-C)
Entity type:Individual
Prefix:
First Name:TAMARIA
Middle Name:
Last Name:DUNN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-2721
Mailing Address - Country:US
Mailing Address - Phone:678-289-6747
Mailing Address - Fax:678-289-6750
Practice Address - Street 1:211 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-2721
Practice Address - Country:US
Practice Address - Phone:678-289-6747
Practice Address - Fax:678-289-6750
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN181866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily