Provider Demographics
NPI:1831942002
Name:WASHINGTON, LILLIE (FNP-C)
Entity type:Individual
Prefix:
First Name:LILLIE
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 HOLCOMB BRIDGE RD STE D
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-4877
Mailing Address - Country:US
Mailing Address - Phone:470-275-3626
Mailing Address - Fax:
Practice Address - Street 1:3780 HOLCOMB BRIDGE RD STE D
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-4877
Practice Address - Country:US
Practice Address - Phone:470-275-3626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906611363LF0000X
AL3-001664363LF0000X
GAGAA-NP001904363LF0000X
GARN334094363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily