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General NPI Number Information
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NPI Number | 1831874395
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Entity Type | Organization
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Legal Business Name | LOTUS GROUP LLC
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Dates
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Enumeration Date | 06/21/2023
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 1605 VERNON RD STE 1600
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City | LAGRANGE
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State | GA
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Zip | 30240-4166
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Country | US
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Telephone | 706-577-2883
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 VERNON RD STE 1600
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City | LAGRANGE
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State | GA
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Zip | 30240-4166
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Country | US
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Telephone | 706-577-2883
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. LETHENIA JOY BAKER
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Credential | MD
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Telephone | 706-577-2883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WN1003X
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Taxonomy Name | Nutrition Support Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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