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General NPI Number Information
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NPI Number | 1891345823
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Entity Type | Individual
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Provider Name | RORY LYN LEMOINE
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Gender | Female
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Dates
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Enumeration Date | 09/11/2019
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 2725 MALL OF GEORGIA BLVD
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City | BUFORD
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State | GA
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Zip | 30519-8791
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Country | US
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Telephone | 678-541-0339
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Fax |
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Provider Business Mailing Address
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Address Line | 3151 DOCKSIDE DR
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City | GAINESVILLE
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State | GA
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Zip | 30501-1470
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Country | US
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Telephone | 678-858-9005
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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 | RN169563
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License Number State | GA
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