Nelson, Tarra Mccullar
Nelson, Tarra Mccullar is an individual health care provider with primary practice located at 1400 Northside Forsyth Dr Ste 250, Cumming GA 30041-7668. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Nelson, Tarra Mccullar can be contacted via phone (770) 889-7118.Contact Information
Primary practice address
1400 Northside Forsyth Dr Ste 250
Cumming GA 30041-7668
Phone: (770) 889-7118
Fax: (770) 844-7835
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | RN112198 | Georgia |
Profile Details
| NPI number | 1295722973 |
|---|---|
| LBN Legal business name | Nelson, Tarra Mccullar |
| Credentials | NP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2005 |
| Last updated | Feb 2nd, 2017 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295722973 | NPPES |
| Georgia | MEDICAID | 000806979H | |
| Georgia | MEDICAID | 000806979I | |
| Georgia | MEDICAID | 000806979J |
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