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Individual

MRS. LILY YADAV

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1501 MILSTEAD RD NE STE 110, CONYERS, GA 30012-3849
(770) 760-9949
(770) 760-9951
Mailing address
1835 SAVOY DR STE 300, ATLANTA, GA 30341-1071
(404) 256-4777
(404) 256-5515

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN252873
GA
363LF0000X
Family Nurse Practitioner
RN252873
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003169065B
GA
05
003169065C
GA
01
20250I1992
MEDICARE PTAN
GA
Enumeration date
10/20/2015
Last updated
08/20/2020
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