Individual
MRS. MAQUISSA LASHANTA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,WHNP
Contact information
Practice address
200 GLEN EAGLE CT STE 5A, CARROLLTON, GA 30117-4267
(770) 377-2456
Mailing address
200 GLEN EAGLE CT STE 4A, CARROLLTON, GA 30117-4267
(770) 377-2456
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN154661
GA
363LW0102X
Women's Health Nurse Practitioner
RN154661
GA
Other
Enumeration date
08/02/2013
Last updated
10/13/2025
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