Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | RN199304 | GA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN199304 | GA |
NPI | 1457703951 |
---|---|
Provider Name | Mabel Lemnyuy Yuyun |
First Address | Atlanta, GA 30350-4901 |
Second Address | Atlanta, GA 30308-2212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2016 |
Last Update Date | 07/07/2016 |