MISS TRACEY LORENA TELLO (NPI# 1417388232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417388232 |
Entity Type | Individual |
Full Name | MISS TRACEY LORENA TELLO |
Credential | CSFA, ST |
Practice Address |
931 Monroe Drive Ne Suite 102 #641 Atlanta GA 30308-7132 |
Mailing Address |
931 Monroe Dr Ne Suite 102 #641 Atlanta GA 30308-1793 |
Practice Telephone | 4043121633 |
Mailing Telephone | 4043121633 |
Enumeration Date | 2013-12-04 |
Last Update Date | 2018-11-28 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
146587 | GA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
931 MONROE DRIVE NE SUITE 102 #641 |
City | ATLANTA |
State | GA |
Zip Code | 30308-7132 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689285165 | Grace Mckinnon Cutchin | Speech-Language Pathologist | 550 Peachtree St. Ne, 9th Floor, Suite 4400, Atlanta, GA 30308 | 2020-08-10 |
1063033942 | Life University | Chiropractor | 1 Baltimore P1. Nw, Suite 100, Atlanta, GA 30308 | 2020-05-01 |
1184254591 | Jordan Cohen | Specialist | 1075 Peachtree Rd, Suite 300, Atlanta, GA 30308 | 2020-01-24 |
1104463819 | Gary Sydney Koech IIi | Registered Nurse | Emory Midtown- Davis Fischer Bld 3rd Floor, Rm 3245a, 550 Peachtree Street, N.e., Atlanta, GA 30308 | 2019-12-02 |
1639728207 | Shannon Oliver Sullivan | Counselor | 1 Baltimore Pl Nw, Suite 360, Atlanta, GA 30308 | 2019-09-06 |
1477110187 | Ariel Alibey | Preventive Medicine | 550 Peachtree St Ne Bldg 4th, Atlanta, GA 30308 | 2019-05-29 |
1972075497 | Laura Mcrae | Nurse Practitioner | Emory Center for Critical Care, 550 Peachtree Street, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-21 |
1265902134 | Kyle Brooks Kraft | Nurse Practitioner | 550 Peachtree Road, Davis Fischer Building, Office 3245a, Atlanta, GA 30308 | 2018-12-04 |
1396211025 | Vita Judkins | Pharmacist | 240 Renaissance Pkway Ne, Unit 116, Atlanta, GA 30308 | 2018-10-20 |
1407345911 | Caitlin Cundiff | Anesthesiology | 550 Peachtree St Ne Ste 3245b, Atlanta, GA 30308 | 2018-05-09 |
Find all providers in zip 30308 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912356775 | Jason Weddington | Physician Assistant | 5667 Peachtree Dunwoody Rd Ste 220, Atlanta, GA 30342-1725 | 2016-06-11 |
1578937181 | Vds Surgical Assistants, Inc. | Physician Assistant | 1307 W Garmon Rd, Atlanta, GA 30327-4405 | 2015-11-19 |
1407220379 | Simpson Surgery Group, LLC | Physician Assistant | 701 Highland Ave Ne Apt 1407, #1407, Atlanta, GA 30312-1454 | 2015-11-16 |
1336587401 | Marissa B Highnote | Physician Assistant | 6045 Barfield Rd Ste 100, Atlanta, GA 30328-4402 | 2013-06-11 |
1396013223 | Signature Surgical Assistants | Physician Assistant | 2489 Kings Arms Dr Ne, Atlanta, GA 30345-2132 | 2011-12-07 |
1720364318 | Leah Strickland | Physician Assistant | 4279 Roswell Road Suite 102 Pmb 303, Atlanta, GA 30342 | 2011-10-26 |
1669798872 | Tiffiany Mccune | Physician Assistant | 4979 Lower Elm St, Atlanta, GA 30349-1677 | 2010-04-13 |
1306177233 | Hong Feng Shi | Physician Assistant | 4355 Cobb Pkwy Ste J131, Atlanta, GA 30339-3887 | 2010-01-15 |
1821256223 | Clyde D Johnson Jr. | Physician Assistant | 5881 Glendrige Dr Ne, Suite 120, Atlanta, GA 30328 | 2008-06-02 |
1043408438 | Samuel Marion | Physician Assistant | 5881 Glenridge Dr Ste 120, Atlanta, GA 30328-8184 | 2007-10-10 |
Find all providers in ATLANTA |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.