1982682340 NPI number — MRS. TERRY APT FNP

Table of content: MS. SCHEENA TANNIS FNP (NPI 1598492761)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982682340 NPI number — MRS. TERRY APT FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
APT
Provider First Name:
TERRY
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
APT
Provider Other First Name:
TERRY
Provider Other Middle Name:
J.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1982682340
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1120 HEATHER WOOD CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARIETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30062-2926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-910-5780
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1395 S MARIETTA PKWY SE STE 730
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARIETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30067-7886
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-763-1456
Provider Business Practice Location Address Fax Number:
404-343-4783
Provider Enumeration Date:
01/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  176831 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 704931144BK , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 704931144A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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