Bradshaw-Small, Lisa Yvonne

Bradshaw-Small, Lisa Yvonne is an sole proprietor health care provider with primary practice located at 6269 Greenock Dr , Stone Mountain GA 30087-6081. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Psychiatric/Mental Health, Adult, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Bradshaw-Small, Lisa Yvonne can be contacted via phone (404) 819-9665.

Contact Information

Primary practice address
6269 Greenock Dr Stone Mountain GA 30087-6081
Phone: (404) 819-9665
Fax: (678) 825-6030
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health, Adult 163WP0809X RN141141 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN141141 Georgia

Profile Details

NPI number 1043330301
LBN Legal business name Bradshaw-Small, Lisa Yvonne
Credentials APRN, BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 30th, 2007
Last updated Apr 5th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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