Healthcare Provider Details

I. General information

NPI: 1013857945
Provider Name (Legal Business Name): TANISHA MAJETTE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8735 DUNWOODY PL # 12467
ATLANTA GA
30350-2995
US

IV. Provider business mailing address

8735 DUNWOODY PL # 12467
ATLANTA GA
30350-2995
US

V. Phone/Fax

Practice location:
  • Phone: 470-998-4557
  • Fax: 770-216-1868
Mailing address:
  • Phone: 470-998-4557
  • Fax: 770-216-1868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN264953
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: