Individual
MS. LARA STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, WHNP-BC
Contact information
Practice address
1700 HOSPITAL SOUTH DR STE 301, AUSTELL, GA 30106-8116
(770) 819-9211
Mailing address
1700 HOSPITAL SOUTH DR STE 301, AUSTELL, GA 30106-8116
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
RN177122
GA
363LP1700X
Perinatal Nurse Practitioner
Primary
RN177122
GA
Other
Enumeration date
07/09/2014
Last updated
03/12/2021
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