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General NPI Number Information
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NPI Number | 1891258174
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Entity Type | Individual
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Provider Name | ALYSSA LAMBERTH
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Gender | Female
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 450 S HILL ST
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City | BUFORD
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State | GA
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Zip | 30518-3220
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Country | US
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Telephone | 678-516-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 2517 STONE MANOR DR
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City | BUFORD
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State | GA
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Zip | 30519-7690
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Country | US
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Telephone | 678-516-4444
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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 | RN213842
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2062688
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License Number State | TX
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