Individual
MS. LISA M FOREMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
9900 MEDLOCK BRIDGE RD, DULUTH, GA 30097-2017
(770) 497-0699
(770) 497-0388
Mailing address
9900 MEDLOCK BRIDGE RD, DULUTH, GA 30097-2017
(770) 497-0699
(770) 497-0388
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN154091
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00164422
RAILROAD MEDICARE
GA
01
—
RN154091
RN LICENSE
GA
Enumeration date
10/05/2005
Last updated
09/03/2008
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