MEDICARE: MRS. MARKEITA LANEICE HOPE PA

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	363A00000X	Physician Assistant	03495	GA

General Provider Information

NPI Number	:	1831392349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARKEITA LANEICE HOPE PA

Provider Business Mailing Address
First Line	:	769 KNOX SPRINGS RD
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30168-6313
Country	:	US
Telephone Number	:	678-463-0253
Fax Number	:

Provider Business Practice Location Address
First Line	:	5580 ROSWELL RD
Second Line	:	SUITE 100
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30342-1861
Country	:	US
Telephone Number	:	404-303-2323
Fax Number	:

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

Provider Enumeration Date	:	06/11/2007
Last Update Date	:	12/01/2025

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