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General NPI Number Information
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NPI Number | 1598229387
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Entity Type | Individual
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Provider Name | YASMINE TIARA ENMON NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/25/2019
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 2256 NORTHLAKE PKWY STE 204A
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City | TUCKER
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State | GA
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Zip | 30084-4004
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Country | US
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Telephone | 770-676-5602
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Fax | 470-906-0391
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Provider Business Mailing Address
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Address Line | 3324 PEACHTREE RD NE UNIT 1107
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City | ATLANTA
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State | GA
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Zip | 30326-1475
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Country | US
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Telephone | 229-251-9495
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN242560
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License Number State | GA
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