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General NPI Number Information
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NPI Number | 1811495518
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Entity Type | Individual
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Provider Name | TUNISIA IYANA AMOS-ISOM FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/28/2018
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 215 MAIN ST STE S2
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City | BARNESVILLE
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State | GA
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Zip | 30204-1469
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Country | US
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Telephone | 423-276-4822
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Fax | 423-205-0826
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Provider Business Mailing Address
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Address Line | 215 MAIN ST STE S2
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City | BARNESVILLE
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State | GA
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Zip | 30204-1469
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Country | US
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Telephone | 423-276-4822
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Fax | 423-205-0826
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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 | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number | APRN211766
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 211766
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 211766
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | APRN211766
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License Number State | GA
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