Provider Demographics
NPI:1922993245
Name:WHITE, TYRONIKA (NP)
Entity type:Individual
Prefix:
First Name:TYRONIKA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TYRONIKA
Other - Middle Name:
Other - Last Name:MURRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4721 BROWNS MILL FERRY RD
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-4535
Mailing Address - Country:US
Mailing Address - Phone:770-568-3621
Mailing Address - Fax:
Practice Address - Street 1:11080 OLD ROSWELL RD STE 200
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-4779
Practice Address - Country:US
Practice Address - Phone:470-240-1283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000000000000000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily