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General NPI Number Information
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NPI Number | 1043496029
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Entity Type | Individual
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Provider Name | LOURDES CRISTINA IRIZAR ARNP
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Gender | Female
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Dates
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Enumeration Date | 01/21/2008
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 1328 JOE FRANK HARRIS PKWY SE
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City | CARTERSVILLE
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State | GA
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Zip | 30120-4221
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Country | US
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Telephone | 770-382-0029
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Fax |
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Provider Business Mailing Address
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Address Line | 420 E 2ND AVE STE 103
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City | ROME
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State | GA
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Zip | 30161-3210
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Country | US
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Telephone | 706-509-3000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP3025842
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License Number State | FL
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