Provider Demographics
NPI:1164609061
Name:JOUBERT, CHRISTY LAU (PA-C)
Entity Type:Individual
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First Name:CHRISTY
Middle Name:LAU
Last Name:JOUBERT
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3495 PIEDMONT ROAD, NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-364-7070
Mailing Address - Fax:770-972-2998
Practice Address - Street 1:750 TORON PARK LAKE
Practice Address - Street 2:KAISER PERMANENTE TORON PARK MEDICAL CENTER
Practice Address - City:KENNESACO
Practice Address - State:GA
Practice Address - Zip Code:30144
Practice Address - Country:US
Practice Address - Phone:770-514-5401
Practice Address - Fax:770-874-5433
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2020-12-02
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Provider Licenses
StateLicense IDTaxonomies
GA005252363A00000X
FLPA9113148363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant