Provider Demographics
NPI:1235624347
Name:FLINT, LISA ANN (APRN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:FLINT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 TERRACE WAY
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-4829
Mailing Address - Country:US
Mailing Address - Phone:828-467-4682
Mailing Address - Fax:
Practice Address - Street 1:50 MEDICAL LN
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-2417
Practice Address - Country:US
Practice Address - Phone:770-345-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-30
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN212669363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner