Provider Demographics
NPI:1790086601
Name:ADAMS, TANYA HANCOCK (NP)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:HANCOCK
Last Name:ADAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:LEIGH
Other - Last Name:HANCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 1110
Mailing Address - Street 2:
Mailing Address - City:DANIELSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30633-1110
Mailing Address - Country:US
Mailing Address - Phone:706-795-9588
Mailing Address - Fax:706-795-0969
Practice Address - Street 1:25 NOMORA DRIVE
Practice Address - Street 2:
Practice Address - City:DANIELSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30633
Practice Address - Country:US
Practice Address - Phone:706-795-9588
Practice Address - Fax:706-795-0969
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN120873363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily