Wallang, Lucy-Bertha

Wallang, Lucy-Bertha is an individual health care provider with primary practice located at 2675 Main St W , Snellville GA 30078-3161. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Wallang, Lucy-Bertha can be contacted via phone (770) 866-5147.

Contact Information

Primary practice address
2675 Main St W Snellville GA 30078-3161
Phone: (770) 866-5147
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 58593 California
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 026102-01 New York
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 9117305 Florida
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 200001685 District of Columbia
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 124154 Iowa
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1131-23 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 004665 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 004665 Georgia

Profile Details

NPI number 1538111539
LBN Legal business name Wallang, Lucy-Bertha
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jun 6th, 2024 - about 5 months 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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Identifiers

StateTypeNumberIssuer
All States NPI 1538111539 NPPES
Georgia MEDICAID 723874491A
Georgia Other 11143
Georgia MEDICAID 723874491B
Georgia Other 01076922
Georgia Other 333656
Georgia MEDICAID 723874491

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