Lisa Dove Blakely, RN
Registered Nurse, Administrator in Atlanta, GA. Individual provider (NPI-1).
NPI number1336678317
StatusActive
Last updated in NPPESMar 17, 2018
Details
- NPI
- 1336678317
- Entity type
- Individual (NPI-1)
- Name
- Lisa Dove Blakely
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 5, 2017
- Last updated
- Mar 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WA2000X | Registered Nurse, Administrator | RN127654 | GA | Yes |
Practice location
1659 Woodbridge Ln NeAtlanta, GA 30329-3536
Phone 678-548-1416
Mailing address
1659 Woodbridge Ln NeAtlanta, GA 30329-3536
Phone 678-548-1416
Other practice locations
1659 Woodbrisge Lane Ne
Atlanta, GA 30329
Atlanta, GA 30329
Phone 678-548-1416
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