Provider Demographics
NPI:1003070491
Name:MONTBELLIER, LISA CHRISTINE (PA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:CHRISTINE
Last Name:MONTBELLIER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1380 UPPER HEMBREE RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1146
Mailing Address - Country:US
Mailing Address - Phone:770-475-2377
Mailing Address - Fax:770-442-0193
Practice Address - Street 1:1380 UPPER HEMBREE RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1146
Practice Address - Country:US
Practice Address - Phone:770-475-2377
Practice Address - Fax:770-442-0193
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2020-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA002403363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant