Healthcare Provider Details

I. General information

NPI: 1104600568
Provider Name (Legal Business Name): LYNN ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 CLIFTON RD NE
ATLANTA GA
30322-4200
US

IV. Provider business mailing address

1525 CLIFTON RD NE
ATLANTA GA
30322-4200
US

V. Phone/Fax

Practice location:
  • Phone: 404-727-7551
  • Fax:
Mailing address:
  • Phone: 404-727-7551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License NumberRN120200
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: