Individual
MRS. LISA M WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
362 B COLUMBIA DRIVE, CARROLLTON, GA 30117
(770) 755-5304
(770) 573-1935
Mailing address
PO BOX 537, TEMPLE, GA 30179-0537
(770) 826-1590
(770) 573-1935
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN137895
GA
163WH0500X
Hemodialysis Registered Nurse
RN137895
GA
363LF0000X
Family Nurse Practitioner
RN137895
GA
Other
Enumeration date
09/02/2011
Last updated
05/23/2017
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