MEDICARE: SITIWE TEMBO EAVES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	341376	GA

General Provider Information

NPI Number	:	1093254997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SITIWE TEMBO EAVES

Provider Business Mailing Address
First Line	:	PO BOX 746087
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6087
Country	:	US
Telephone Number	:	312-733-9730
Fax Number	:

Provider Business Practice Location Address
First Line	:	1372 PEACHTREE ST NE STE 100
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-3248
Country	:	US
Telephone Number	:	470-964-1700
Fax Number	:	678-288-5639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2017
Last Update Date	:	11/05/2025

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Directions to “ SITIWE TEMBO EAVES ” Practice Location

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