Healthcare Provider Details

I. General information

NPI: 1669306759
Provider Name (Legal Business Name): LIZ ETEL ALARCON DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 HENDERSON DR STE 504
CARTERSVILLE GA
30120-3738
US

IV. Provider business mailing address

650 HENDERSON DR STE 504
CARTERSVILLE GA
30120-3760
US

V. Phone/Fax

Practice location:
  • Phone: 770-607-9032
  • Fax: 770-607-9035
Mailing address:
  • Phone: 770-607-9032
  • Fax: 770-607-9035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP005172
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: