Provider Demographics
NPI:1740741438
Name:LAMBERTH, GIORGIA GRACE (CRNP)
Entity Type:Individual
Prefix:
First Name:GIORGIA
Middle Name:GRACE
Last Name:LAMBERTH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-7288
Mailing Address - Country:US
Mailing Address - Phone:334-361-3090
Mailing Address - Fax:
Practice Address - Street 1:204 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7288
Practice Address - Country:US
Practice Address - Phone:334-361-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-164677163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse