Provider Demographics
NPI:1881318335
Name:SOSNOWSKI-LEE, JEANETTE ELIZABETH (CPNP-AC)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:ELIZABETH
Last Name:SOSNOWSKI-LEE
Suffix:
Gender:F
Credentials:CPNP-AC
Other - Prefix:
Other - First Name:JEANETTE
Other - Middle Name:ELIZABETH
Other - Last Name:SOSNOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5461 MERIDIAN MARK RD STE 329
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-3007
Mailing Address - Country:US
Mailing Address - Phone:404-785-3240
Mailing Address - Fax:
Practice Address - Street 1:1405 CLIFTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1060
Practice Address - Country:US
Practice Address - Phone:404-785-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN315189363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics