Healthcare Provider Details

I. General information

NPI: 1336510205
Provider Name (Legal Business Name): LISE-STEPHANA FRANCOIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2015
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1762 MARS HILL RD NW
ACWORTH GA
30101-8091
US

IV. Provider business mailing address

2675 PACES FERRY RD SE
ATLANTA GA
30339-4052
US

V. Phone/Fax

Practice location:
  • Phone: 404-948-3019
  • Fax:
Mailing address:
  • Phone: 678-504-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN189849
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN189849
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: