Provider Demographics
NPI:1275960510
Name:BATTLE, TABE (NP-C)
Entity type:Individual
Prefix:
First Name:TABE
Middle Name:
Last Name:BATTLE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GREENWAY BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-4358
Mailing Address - Country:US
Mailing Address - Phone:443-735-5030
Mailing Address - Fax:
Practice Address - Street 1:706 DIXIE ST STE 320
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3890
Practice Address - Country:US
Practice Address - Phone:770-836-9326
Practice Address - Fax:770-836-9358
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPRN-NP256755363L00000X
DELG-0000717363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner