Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shan David Tully, FNP-C

Individual provider Nurse Practitioner · NPI 1275498131

Shan David Tully, FNP-C is a Nurse Practitioner in Hiram, Georgia. Licensed in Georgia. Registered with an NPI since 2025.

Licensed in
GA
In the registry since
2025
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

6736 Bill Carruth Pkwy Apt 805
Hiram, GA 30141-3794
Phone: (470) 330-0826
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence APRN-NP294893 (GA)

Record details

NPI number1275498131
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedDecember 22, 2025
Last updated in NPPESDecember 22, 2025
Certification dateDecember 22, 2025

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