Shan Tully, FNP-C

NPI 1275498131 · on the registry since 2025

Practice

Address: 6736 Bill Carruth Pkwy Apt 805
Hiram, GA 30141
Phone: (470) 330-0826
Organisation at this address: Liz Moon Llc
Renewed Pathways Llc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: Nurse Practitioner
363L00000X
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-12-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia