Healthcare Provider Details

I. General information

NPI: 1326675380
Provider Name (Legal Business Name): TANKEIA TANYE' WARREN MSN, APRN, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE
ATLANTA GA
30322-1013
US

IV. Provider business mailing address

1365 CLIFTON RD NE
ATLANTA GA
30322-1013
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-9850
  • Fax:
Mailing address:
  • Phone: 404-785-9850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN213651
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberRN213651
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: