Individual
WILLIE LITHGOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
20 HERRELL RD, VILLA RICA, GA 30180-5527
(770) 812-3928
Mailing address
20 HERRELL RD, VILLA RICA, GA 30180-5527
(770) 812-3928
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN205649
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN-NP205649
GA
Other
Enumeration date
02/08/2024
Last updated
11/19/2025
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