Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN251199 | GA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN251199 | GA |
NPI | 1043703093 |
---|---|
Provider Name | Lorraine Elizabeth Mcdowell |
First Address | Lilburn, GA 30047-3093 |
Second Address | Norcross, GA 30071 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2018 |
Last Update Date | 25/07/2018 |