Basic Information
| Provider Information | |||||||||
| NPI: | 1780731729 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRELL-BOYD | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | |||||||||
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| Credential: | APRN,ACNP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BOYD | ||||||||
| OtherFirstName: | LISA | ||||||||
| OtherMiddleName: | H | ||||||||
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| OtherCredential: | APRN, ACNP | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 550 PEACHTREE ST NE | ||||||||
| Address2: | DAVIS-FISCHER BUILDING, OFFICE 3245A | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303082208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046867858 | ||||||||
| FaxNumber: | 4046867841 | ||||||||
| Practice Location | |||||||||
| Address1: | 550 PEACHTREE ST NE | ||||||||
| Address2: | DAVIS-FISCHER BUILDING, OFFICE 3245A | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303082208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046867858 | ||||||||
| FaxNumber: | 4046867841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 12/08/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN164156 | GA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LC0200X | RN164156 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Critical Care Medicine |
No ID Information.