Individual
MRS. LISA MACOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4000 SHAKERAG HL, SUITE 201, PEACHTREE CITY, GA 30269-4047
(770) 486-7111
(770) 486-7131
Mailing address
4000 SHAKERAG HL, SUITE 201, PEACHTREE CITY, GA 30269-4047
(770) 486-7111
(770) 486-7131
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN134284 NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
668569165F
—
GA
Enumeration date
05/16/2008
Last updated
02/21/2012
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