Individual
SHANDRA LUNETTE HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
116 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2527
(404) 564-7042
(404) 241-6256
Mailing address
1046 RIDGE AVE SW, ATLANTA, GA 30315-1640
(404) 688-1350
(470) 593-7784
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10236
GA
363A00000X
Physician Assistant
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—
Other
Enumeration date
02/11/2021
Last updated
11/20/2023
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