Individual
GRACE OLIVIA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(770) 778-9468
Mailing address
4044 ANCIENT AMBER WAY, NORCROSS, GA 30092-5119
(770) 778-9468
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN272386
GA
Other
Enumeration date
02/27/2019
Last updated
02/27/2019
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