Individual
MARY REBECCA LYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 COLLIER RD NW STE 635, ATLANTA, GA 30309-1611
(404) 367-3014
Mailing address
1087 MERRITT RD, MARIETTA, GA 30062-3243
(678) 895-2620
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN210107
GA
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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