Individual
LUCINDA JOHNSON SELLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
5405 MEMORIAL DR STE D, STONE MOUNTAIN, GA 30083-3236
(404) 296-3800
(404) 297-8753
Mailing address
5405 MEMORIAL DR STE D, STONE MOUNTAIN, GA 30083-3236
(404) 296-3800
(404) 297-8753
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN204724
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003107139A
—
GA
Enumeration date
11/19/2010
Last updated
03/06/2019
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