Healthcare Provider Details

I. General information

NPI: 1194703181
Provider Name (Legal Business Name): LISA PINKARD ACREE ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA MICHELL PINKARD

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W 5TH ST SW
ROME GA
30165-2817
US

IV. Provider business mailing address

420 E 2ND AVE STE 103
ROME GA
30161-3210
US

V. Phone/Fax

Practice location:
  • Phone: 706-528-9110
  • Fax: 706-528-9111
Mailing address:
  • Phone: 706-509-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN126710
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: