Individual provider · NPI-1

Emmeline Wynn Lombard, PAC

Physician Assistant · Lithonia, GA

NPI number1750004651
StatusActive
Last updated in NPPESSep 16, 2026

Details

NPI
1750004651
Entity type
Individual (NPI-1)
Name
Emmeline Wynn Lombard
Credential
PAC
Sex
Female
Sole proprietor
No
Enumeration date
Sep 26, 2022
Certification date
Sep 16, 2026
Last updated
Sep 16, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant12270GAYes

Practice location

5403 Hillandale Park Ct Ste B
Lithonia, GA 30058-8845

Phone 770-817-0224 · Fax 770-817-0228

Mailing address

5403 Hillandale Park Ct Ste B
Lithonia, GA 30058-8845

Phone 770-817-0224 · Fax 770-817-0228

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