Provider Demographics
NPI:1578637864
Name:TUTT, CHANDILA YVETTE (RN, CNS, FNP)
Entity Type:Individual
Prefix:MS
First Name:CHANDILA
Middle Name:YVETTE
Last Name:TUTT
Suffix:
Gender:F
Credentials:RN, CNS, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SYCAMORE STA
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2764
Mailing Address - Country:US
Mailing Address - Phone:404-276-9489
Mailing Address - Fax:
Practice Address - Street 1:34 SYCAMORE STA
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2764
Practice Address - Country:US
Practice Address - Phone:404-276-9489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA116406163WC0200X
GAR116406364SC0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine