Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | RN252890 | GA |
N | 363LC1500X | Nurse Practitioner - Community Health | RN252890 | GA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN252890 | GA |
N | 363LP2300X | Nurse Practitioner - Primary Care | RN252890 | GA |
NPI | 1366008237 |
---|---|
Provider Name | Melissa Lee Hallman |
First Address | Atlanta, GA 30312-1488 |
Second Address | Atlanta, GA 30309-3040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2019 |
Last Update Date | 30/01/2020 |