Mrs Lisa Michelle Mckinnon, CPNP is a medicare enrolled "Nurse Practitioner" physician in Atlanta, Georgia. Her current practice location is
1400 Tullie Rd Ne, Atlanta, Georgia. You can reach out to her office (for appointments etc.) via phone at
(404) 785-9344.
Mrs Lisa Michelle Mckinnon is licensed to practice in Georgia (license number 1497213045) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1497213045.
Physician's Profile
Full Name | Mrs Lisa Michelle Mckinnon |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Location | 1400 Tullie Rd Ne, Atlanta, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1497213045
- Provider Enumeration Date: 03/02/2019
- Last Update Date: 03/21/2023
Medicare PECOS Information:
- PECOS PAC ID: 8820421159
- Enrollment ID: I20191127001078
Medical Identifiers
Medical identifiers for Mrs Lisa Michelle Mckinnon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1497213045 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | RN223686 (Georgia) | Secondary |
363L00000X | Nurse Practitioner | 1497213045 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Lisa Michelle Mckinnon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Lisa Michelle Mckinnon, CPNP 9835 Rod Rd, Johns Creek, GA 30022-5077 Ph: (404) 784-0242 | Mrs Lisa Michelle Mckinnon, CPNP 1400 Tullie Rd Ne, Atlanta, GA 30329-2309 Ph: (404) 785-9344 |
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