MEDICARE: LISA K CULPEPPER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	RN176012 NP	GA

General Provider Information

NPI Number	:	1760790125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA K CULPEPPER NP

Provider Business Mailing Address
First Line	:	993 JOHNSON FERRY RD STE 210
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-1620
Country	:	US
Telephone Number	:	404-256-1727
Fax Number	:	404-252-3591

Provider Business Practice Location Address
First Line	:	993 JOHNSON FERRY RD STE 210
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-1620
Country	:	US
Telephone Number	:	404-256-1727
Fax Number	:	404-252-3591

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	12/10/2025

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