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Practitoners Community Care
Adult Health Nurse Practitioner in Lithia Springs, Georgia
NPI 1043860554

Practitoners Community Care is an Adult Health Nurse Practitioner based in Lithia Springs, GA and is specialized in Adult Health. Practitoners Community Care practices in Lithia Springs, GA. The NPI Number for Practitoners Community Care is 1043860554 and holds a License No. (Georgia).

The current practice location address for Practitoners Community Care is 870 Crestmark Dr Ste 200, Lithia Springs, GA and can be reached out via phone at 770-374-7062.

Location: 870 Crestmark Dr Ste 200, Lithia Springs, GA, 30122-2665
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1043860554
Provider Name
Practitoners Community Care
Credential
Provider Entity Type
Organization
Address
870 Crestmark Dr Ste 200, Lithia Springs, GA, 30122-2665
Phone Number
770-374-7062
Fax Number
Provider Enumeration Date
09/17/2019
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
Q03882281 01 GA MEDICARE
003227729B 05 GA
institution
Provider Business Practice Location Address Details
Address
870 Crestmark Dr Ste 200
City
Lithia Springs
State
Georgia
Zip
30122-2665
Phone Number
770-374-7062
Fax Number
person
Provider Business Mailing Address Details
Address
870 Crestmark Dr Ste 200
City
Lithia Springs
State
Georgia
Zip
30122-2665
Phone Number
770-374-7062
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
()
Definition
Definition to come...
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