Healthcare Provider Details

I. General information

NPI: 1255278875
Provider Name (Legal Business Name): HANNAH DUPRIEST TANNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 E WASHINGTON AVE
ASHBURN GA
31714-5248
US

IV. Provider business mailing address

130 COUNTRY WOODS CT
POULAN GA
31781-3459
US

V. Phone/Fax

Practice location:
  • Phone: 229-567-4414
  • Fax: 229-567-4419
Mailing address:
  • Phone: 229-272-1597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP313521
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: