Individual
LISA CLEVLELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
105 ARTHUR CT, FAYETTEVILLE, GA 30214-4407
(404) 200-0028
Mailing address
105 ARTHUR CT, FAYETTEVILLE, GA 30214-4407
(404) 200-0028
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN228026
GA
Other
Enumeration date
02/26/2015
Last updated
02/26/2015
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