Individual
MRS. LISA A SAMPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-AC
Contact information
Practice address
3950 AUSTELL RD, AUSTELL, GA 30106-1121
(470) 732-5299
Mailing address
4407 BLACK HILLS DR NW, ACWORTH, GA 30101-1422
(678) 591-7015
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN224696
GA
Other
Enumeration date
01/29/2018
Last updated
06/23/2020
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