MEDICARE: MRS. TASHA M PRICE FNP

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	363L00000X	Nurse Practitioner	RN244445	GA
2	363L00000X	Nurse Practitioner	677806	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396806865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TASHA M PRICE FNP

Provider Business Mailing Address
First Line	:	409 SYCAMORE TRL
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-7425
Country	:	US
Telephone Number	:	806-433-2122
Fax Number	:

Provider Business Practice Location Address
First Line	:	61 WHITCHER ST NE STE 2100
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060-1179
Country	:	US
Telephone Number	:	770-423-0595
Fax Number	:

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

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	04/13/2023

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Directions to “ MRS. TASHA M PRICE FNP” Practice Location

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