Provider Demographics
NPI:1487358990
Name:TIERNEY, ALANA BLOCKER (PA-C)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:BLOCKER
Last Name:TIERNEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6919 PEACHTREE DUNWOODY RD APT 444
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-1736
Mailing Address - Country:US
Mailing Address - Phone:256-487-1113
Mailing Address - Fax:
Practice Address - Street 1:1100 JOHNSON FERRY RD STE 510
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2794
Practice Address - Country:US
Practice Address - Phone:943-888-9006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
GA11504363AM0700X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical