Individual provider · Type 1 NPI
Shan David Tully, FNP-C
Nurse Practitioner · Hiram, GA
Practice location
6736 Bill Carruth Pkwy Apt 805
Hiram, GA 30141-3794
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | APRN-NP294893 (GA) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1275498131
Shan David Tully, FNP-C's National Provider Identifier is 1275498131, issued on Dec 22, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Hiram, GA. The record was last updated on Dec 22, 2025.