Provider Demographics
NPI:1821604158
Name:GALLEMORE, TEKERIA (MSN,APRN,FNP)
Entity Type:Individual
Prefix:
First Name:TEKERIA
Middle Name:
Last Name:GALLEMORE
Suffix:
Gender:F
Credentials:MSN,APRN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 SPRING ST STE 230
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-2185
Mailing Address - Country:US
Mailing Address - Phone:478-633-1547
Mailing Address - Fax:
Practice Address - Street 1:781 SPRING ST STE 230
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2185
Practice Address - Country:US
Practice Address - Phone:478-633-1547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN250476363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner