Healthcare Provider Details

I. General information

NPI: 1730029687
Provider Name (Legal Business Name): ALLANIS LISBETH-MARIE MILLS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 FLAT SHOALS RD SE
CONYERS GA
30013-1809
US

IV. Provider business mailing address

4850 SUGARLOAF PKWY STE 501
LAWRENCEVILLE GA
30044-2864
US

V. Phone/Fax

Practice location:
  • Phone: 770-922-1778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP306886
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: