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General NPI Number Information
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NPI Number | 1780188359
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Entity Type | Individual
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Provider Name | LISA CALHOUN CPNP
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Gender | Female
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 1605 COLLINS RD NW
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City | KENNESAW
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State | GA
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Zip | 30152-4309
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Country | US
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Telephone | 770-427-0183
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Fax |
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Provider Business Mailing Address
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Address Line | 3880 DONALDSON DR
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City | ATLANTA
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State | GA
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Zip | 30341-1713
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Country | US
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Telephone | 248-943-5055
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN312751
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License Number State | GA
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