Individual
DR. LISA MCCORD HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4135 KEMPER CT, EVANS, GA 30809-4068
(706) 306-5187
Mailing address
4135 KEMPER CT, EVANS, GA 30809-4068
(706) 306-5187
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
049168
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
833155790
—
GA
Enumeration date
01/15/2019
Last updated
01/15/2019
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