Individual
MISS LISA MULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
601 S 8TH ST, ER DEPT, GRIFFIN, GA 30224-4213
(770) 228-2721
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN155767
GA
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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