| Amanda Faye Tison, APRN, FNP-C | |
|
4837 Bill Gardner Pkwy Ste B, Locust Grove, GA 30248-3734 | |
| (678) 800-1602 | |
| Not Available |
| Full Name | Amanda Faye Tison |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 4837 Bill Gardner Pkwy Ste B, Locust Grove, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164088977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 11002465 (Florida) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | GAA-NP000337 (Georgia) | Primary |
| Entity Name | Peachtree Immediate Care Fp, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437194156 PECOS PAC ID: 3274559323 Enrollment ID: O20051019000049 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Faye Tison, APRN, FNP-C 72 Bolingview Rd, Juliette, GA 31046-3932 Ph: (904) 507-1221 | Amanda Faye Tison, APRN, FNP-C 4837 Bill Gardner Pkwy Ste B, Locust Grove, GA 30248-3734 Ph: (678) 800-1602 |
Mahlory Carey, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 175 Hacienda Ave, Locust Grove, GA 30248 Phone: 678-749-1431 | |
Bridgette G Williams, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1201 Nottley Dr, Locust Grove, GA 30248 Phone: 770-597-7739 | |
Florence Achilihu Adiele, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5293 Heron Bay Blvd, Locust Grove, GA 30248 Phone: 706-769-7658 | |
Chavonn Done Davidson-smith, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3000 Norwell Ct, Locust Grove, GA 30248 Phone: 770-634-7470 | |
Michelle Denise Bush, RN, MSN, CRNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3758 Highway 42, Locust Grove, GA 30248 Phone: 678-561-9430 Fax: 770-914-1070 | |
Deandra Lashay White, APRNC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3366 Highway 42 S Ste 110, Locust Grove, GA 30248 Phone: 770-898-4339 |