DR. SUZANNE RENEE TAMBASCO NP NPI 1417500786

NPI Information

NPI: 1417500786
Provider Name: DR. SUZANNE RENEE TAMBASCO, NP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
210 TRILITH PKWY
FAYETTEVILLE, GA
ZIP 30214
Phone: (770) 309-5891
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DR. Suzanne Renee Tambasco, NP is a psychiatric/mental health nurse practitioner in Fayetteville, GA. DR. Suzanne Renee Tambasco, NP NPI is 1417500786. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

210 TRILITH PKWY
FAYETTEVILLE, GA
ZIP 30214-616
Phone: (770) 309-5891

The NPI 1417500786 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/16/2019 and was last updated on 7/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	155955	GEORGIA	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	259122	ARIZONA	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	24185688	VIRGINIA	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	114662	WEST VIRGINIA	No
5	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	11022333	FLORIDA	No
6	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	0002821	COLORADO	No
7	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	202102650	OREGON	No
8	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	CNP-63745	NEW MEXICO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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