| Doctor Name: | MRS. CRISTIANE LEMOS FUKUDA |
| NPI Number: | 1356665889 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 158316 |
| Business Practice Address: | 5212 Pine Branch Cir Sugar Hill, GA - 305187616 |
| Business Phone Number: | 6789784801 |
| Business Fax Number: | |
| Mailing Address: | 4720 Nelson Brogdon Blvd, BUFORD |
| State: | GA |
| Postal Code: | 305183480 |
| Phone Number: | 6789784801 |
| Fax Number: | |
| NPI Enumeration Date: | 03/26/2010 |
| NPI Last Update Date: | 06/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 158316 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |