Provider Demographics
NPI:1083851919
Name:TARVER, PAMELA G (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:G
Last Name:TARVER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2665 N DECATUR RD
Mailing Address - Street 2:SUITE 430
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6149
Mailing Address - Country:US
Mailing Address - Phone:404-294-4018
Mailing Address - Fax:404-294-9161
Practice Address - Street 1:2665 N DECATUR RD
Practice Address - Street 2:SUITE 430
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6149
Practice Address - Country:US
Practice Address - Phone:404-294-4018
Practice Address - Fax:404-294-9161
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN164778NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care