Individual
RESA A LORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
705 17TH ST, SUITE 107, COLUMBUS, GA 31901-3500
(706) 571-1665
(706) 660-2699
Mailing address
705 17TH ST, SUITE 107, COLUMBUS, GA 31901-3500
(706) 571-1665
(706) 660-2699
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN087816
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN087816
LICENSE
GA
Enumeration date
04/15/2008
Last updated
04/15/2008
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