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Individual

SUSAN E. LOMAX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
777 FRANKLIN RD SE, MARIETTA, GA 30067-7803
(770) 732-6007
(770) 732-8242
Mailing address
777 FRANKLIN RD SE, MARIETTA, GA 30067-7803
(770) 732-6007
(770) 732-8242

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
117846
GA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN117846
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000874057I
GA
01
11194873828
NPI
GA
01
818552480A
MEDICAID PAYEE ID
GA
05
818552480A
GA
Enumeration date
01/08/2007
Last updated
08/01/2012
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