Provider Demographics
NPI:1457040768
Name:AITKENS, LORRY ELIZABETH
Entity Type:Individual
Prefix:
First Name:LORRY
Middle Name:ELIZABETH
Last Name:AITKENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LIZ
Other - Middle Name:
Other - Last Name:AITKENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:606 CHESTNUT HALL LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4702
Mailing Address - Country:US
Mailing Address - Phone:404-313-8036
Mailing Address - Fax:
Practice Address - Street 1:606 CHESTNUT HALL LN
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4702
Practice Address - Country:US
Practice Address - Phone:404-313-8036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program