Individual
LISA LYNNETTE ANGELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501
(770) 219-9000
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
18853
TN
363LA2100X
Acute Care Nurse Practitioner
RN287463
GA
363LG0600X
Gerontology Nurse Practitioner
Primary
18853
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q008989
—
TN
Enumeration date
09/11/2014
Last updated
11/13/2025
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