Provider Demographics
NPI:1477701753
Name:LATHROP, BREANNA LYNN (FNP-BC, MSN, MPH)
Entity Type:Individual
Prefix:MRS
First Name:BREANNA
Middle Name:LYNN
Last Name:LATHROP
Suffix:
Gender:F
Credentials:FNP-BC, MSN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 BOULEVARD SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-3016
Mailing Address - Country:US
Mailing Address - Phone:404-635-1300
Mailing Address - Fax:404-635-1320
Practice Address - Street 1:1350 BOULEVARD SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-3016
Practice Address - Country:US
Practice Address - Phone:404-635-1300
Practice Address - Fax:404-635-1320
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN184089363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily