Individual
LISA KIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
119 GOLDEN POND BLVD, BONAIRE, GA 31005-4427
(478) 258-6636
(478) 258-6636
Mailing address
119 GOLDEN POND BLVD, BONAIRE, GA 31005-4427
(478) 258-6636
(478) 258-6636
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
RN258735
GA
363L00000X
Nurse Practitioner
Primary
RN258735
GA
Other
Enumeration date
04/03/2025
Last updated
05/29/2025
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