Provider Demographics
NPI:1841808169
Name:TRAN, TAMI AYALA (APRN)
Entity type:Individual
Prefix:
First Name:TAMI
Middle Name:AYALA
Last Name:TRAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:101 RIVERSTONE VIS STE 111
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-6665
Mailing Address - Country:US
Mailing Address - Phone:706-492-3200
Mailing Address - Fax:706-492-3206
Practice Address - Street 1:101 RIVERSTONE VIS STE 111
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-6665
Practice Address - Country:US
Practice Address - Phone:706-492-3200
Practice Address - Fax:706-492-3206
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11006208363LF0000X
GAGAA-NP000662363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily