NPI age
5 years
Enumerated 2020-11-09
● Active
Type 1 · Individual
Kristti Lei Birondo Tan, AGNP-BC
Tan is 1 of 4 nurse practitioner providers in Douglasville and 1 of 280 in Georgia.
Primary specialty
Nurse Practitioner
Plus 2 subspecialties
Licensed in
TN, TX, NY
3 states
Status
Active
No deactivations on record
Last NPPES update
2026-04-16
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 280 active nurse practitioner providers in Georgia.
NPI age
5 years
↓ 2 yr below median (7 yr)
State licenses
3 states
Top 88% — 11% of peers are multi-state
Subspecialties
1
In the 35% of peers with subspecialties
NPI lifetime · 2020 → 2026
2020-11Enumerated in NPPES
2020
2026
Where they practice
Practice location
4645 Timber Ridge Dr Ste 100
Douglasville, GA 301357542
Mailing address
3320 Perimeter Hill Dr
Nashville, TN 372114123
Specialties
-
Nurse Practitioner PrimaryDefinition to come...
-
Nurse PractitionerDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TN) | Q079530 |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.