Individual
JENINA PEREZ LAGASCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
95 COLLIER RD NW, SUITE 5015, ATLANTA, GA 30309-1796
(404) 605-5699
(404) 355-4235
Mailing address
95 COLLIER RD NW, SUITE 5015, ATLANTA, GA 30309-1796
(404) 605-5699
(404) 355-4235
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN172230
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003107002A
—
GA
Enumeration date
01/28/2010
Last updated
05/02/2011
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