Individual
MAYLISSA LYDIA DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2275 MARIETTA BLVD NW STE 450, ATLANTA, GA 30318-2004
(404) 367-4400
Mailing address
2275 MARIETTA BLVD NW STE 450, ATLANTA, GA 30318-2004
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
GAA-NP000646
GA
363L00000X
Nurse Practitioner
Primary
GAA-NP000646
GA
Other
Enumeration date
06/27/2022
Last updated
11/26/2025
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