Doctor Name: | RESA A LORD |
NPI Number: | 1003080789 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPNP |
License Number: | RN087816 |
Business Practice Address: | 705 17th St Suite 107 Columbus, GA - 319013500 |
Business Phone Number: | 7065711665 |
Business Fax Number: | 7066602699 |
Mailing Address: | 705 17th St, Suite 107 COLUMBUS |
State: | GA |
Postal Code: | 319013500 |
Phone Number: | 7065711665 |
Fax Number: | 7066602699 |
NPI Enumeration Date: | 04/15/2008 |
NPI Last Update Date: | 04/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | RN087816 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |