Provider Demographics
NPI:1609200591
Name:GETER-BARKER, TIFFANY SHREMAIN
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:SHREMAIN
Last Name:GETER-BARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:SHREMAIN
Other - Last Name:GETER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA
Mailing Address - Street 1:83 FIRST AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30236
Mailing Address - Country:US
Mailing Address - Phone:470-233-1277
Mailing Address - Fax:
Practice Address - Street 1:83 FIRST AVE
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-2763
Practice Address - Country:US
Practice Address - Phone:470-233-1277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030022871374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide