Provider Demographics
NPI:1073885133
Name:TARABICOS, ANNA-LISA MARIE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANNA-LISA
Middle Name:MARIE
Last Name:TARABICOS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:470 SADDLEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2446
Mailing Address - Country:US
Mailing Address - Phone:678-612-9301
Mailing Address - Fax:678-884-8100
Practice Address - Street 1:3795 MANSELL RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-8247
Practice Address - Country:US
Practice Address - Phone:678-612-9301
Practice Address - Fax:678-884-8100
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN148036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily