Organization
CLAYTON STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY SUSAN LANE RN, PH.D., FNP-C (CHAIR NURSING)
(678) 466-4953
Entity
Organization
Contact information
Practice address
5809 NORTHLAKE DRIVE, BLDG 1000, MORROW, GA 30260
(678) 466-5590
(678) 466-4999
Mailing address
2000 CLAYTON STATE BLVD, MORROW, GA 30260
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/06/2015
Last updated
12/04/2015
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