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General NPI Number Information
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NPI Number | 1891831814
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Entity Type | Individual
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Provider Name | LISA JEANNINE CROW DEMARS NP
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Gender | Female
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 304 PINEMOUNT DR
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1237
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Country | US
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Telephone | 404-290-7442
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Fax |
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Provider Business Mailing Address
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Address Line | 304 PINEMOUNT DR
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1237
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Country | US
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Telephone | 404-290-7442
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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 | RN107984NP
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License Number State | GA
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