Individual provider · Type 1 NPI
Tina Betty Ezeolisah, DNP, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Duluth, GA
NPI number
1306299268
Active
Practice location
3355 Mcdaniel Rd, Apt 17401
Duluth, GA 30096-8613
Mailing address
1814 Clairmont Rd
Decatur, GA 30033-3405
Other practice locations
- 940 Concord Rd SE, Smyrna, GA 30080-4204 · (404) 636-1457
- 1814 Clairmont Rd, Decatur, GA 30033-3405 · (404) 636-1457
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN2345725 (MA) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | C-APN.0002066-C-NP (CO) |
| Registered Nurse | 163W00000X | RN 217223 (GA) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 05031 (RI) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | RN217223 (GA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1306299268
Tina Betty Ezeolisah, DNP, PMHNP-BC's National Provider Identifier is 1306299268, issued on Jul 15, 2016. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Duluth, GA. The record was last updated on Dec 2, 2022.