Needham-Jackson, Tisharie
Needham-Jackson, Tisharie is an individual health care provider with primary practice located at 1412 Milstead Ave Ne , Conyers GA 30012-3877. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Emergency, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Needham-Jackson, Tisharie can be contacted via phone (404) 605-2800.Contact Information
Primary practice address
1412 Milstead Ave Ne
Conyers GA 30012-3877
Phone: (404) 605-2800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Emergency | 163WE0003X | RN234785 | Georgia |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | RN234785 | Georgia |
Profile Details
| NPI number | 1780253229 |
|---|---|
| LBN Legal business name | Needham-Jackson, Tisharie |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 19th, 2021 |
| Last updated | Jun 22nd, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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