Individual
LISA AILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2737 WARM SPRINGS ROAD, COLUMBUS, GA 31904
(706) 653-2255
Mailing address
4519 WOODRUFF ROAD, SUITE 4 PMB 349, COLUMBUS, GA 31904
(706) 653-2255
(706) 653-2329
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN243650
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN243650
GA SECRETARY OF STATE
GA
Enumeration date
01/28/2015
Last updated
01/28/2015
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