Provider Demographics
NPI:1437595501
Name:VALDES, LISSETTE MARIA ESTEVEZ (MMSC, PA-C)
Entity Type:Individual
Prefix:MS
First Name:LISSETTE
Middle Name:MARIA ESTEVEZ
Last Name:VALDES
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Gender:F
Credentials:MMSC, PA-C
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Mailing Address - Street 1:1462 CLIFTON ROAD, N.E., SUITE 280
Mailing Address - Street 2:EMORY UNIVERSITY PHYSICIAN ASSISTANT PROGRAM
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-727-2581
Mailing Address - Fax:
Practice Address - Street 1:4500 NORTH SHALLOWFORD ROAD
Practice Address - Street 2:EMORY FAMILY MEDICINE CLINIC
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338
Practice Address - Country:US
Practice Address - Phone:404-778-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
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Provider Licenses
StateLicense IDTaxonomies
GA003267363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical