Provider Demographics
NPI:1861812976
Name:TOMLIN, RYLANDA
Entity Type:Individual
Prefix:
First Name:RYLANDA
Middle Name:
Last Name:TOMLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1444
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:GA
Mailing Address - Zip Code:31008-1444
Mailing Address - Country:US
Mailing Address - Phone:478-213-1404
Mailing Address - Fax:
Practice Address - Street 1:212 GA HIGHWAY 49 N
Practice Address - Street 2:SUITE 1400
Practice Address - City:BYRON
Practice Address - State:GA
Practice Address - Zip Code:31008-4057
Practice Address - Country:US
Practice Address - Phone:478-213-1404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030000290376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide