Healthcare Provider Details

I. General information

NPI: 1609756196
Provider Name (Legal Business Name): MEI LING LI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 S HILL ST
GRIFFIN GA
30224-4830
US

IV. Provider business mailing address

115 JENNIFER LN
MCDONOUGH GA
30253-5436
US

V. Phone/Fax

Practice location:
  • Phone: 770-228-5407
  • Fax:
Mailing address:
  • Phone: 347-720-9501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN308682
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: