Grall, Tina M.

Grall, Tina M. is an individual health care provider with primary practice located at 1045 Southcrest Dr Suite 200, Stockbridge GA 30281-6113. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Grall, Tina M. can be contacted via phone (678) 289-0549.

Contact Information

Primary practice address
1045 Southcrest Dr Suite 200 Stockbridge GA 30281-6113
Phone: (678) 289-0549
Fax: (678) 289-8756
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN060199 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN060199 Georgia

Profile Details

NPI number 1386181089
LBN Legal business name Grall, Tina M.
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2017
Last updated Sep 1st, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386181089 NPPES
Georgia MEDICAID 003185368A
Georgia MEDICAID 003185368B
Georgia Other 202I504936

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