| Doctor Name: | CHERRY LEE TISON |
| NPI Number: | 1184062572 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | RN138701 |
| Business Practice Address: | 424 N Main St Cedartown, GA - 301252644 |
| Business Phone Number: | 7707482500 |
| Business Fax Number: | |
| Mailing Address: | 420 E 2nd Ave, Suite 103 ROME |
| State: | GA |
| Postal Code: | 301613209 |
| Phone Number: | 7065093000 |
| Fax Number: | |
| NPI Enumeration Date: | 06/07/2013 |
| NPI Last Update Date: | 06/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | RN138701 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |