Mrs Lisa Yvonne Bradshaw-small, APRN, BC - Nurse Practitioner in Stone Mountain, GA

Mrs Lisa Yvonne Bradshaw-small, APRN, BC is a Nurse Practitioner - Family based in Stone Mountain, Georgia. Mrs Lisa Yvonne Bradshaw-small is licensed to practice in Georgia (license number RN141141) and her current practice location is 6269 Greenock Dr, Stone Mountain, Georgia. She can be reached at her office (for appointments etc.) via phone at (404) 819-9665.

NPI number for Mrs Lisa Yvonne Bradshaw-small is 1043330301 and her current mailing address is 6269 Greenock Dr, Stone Mountain, Georgia. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1043330301.

Contact Information

Mrs Lisa Yvonne Bradshaw-small, APRN, BC
6269 Greenock Dr,
Stone Mountain, GA 30087-6081
(404) 819-9665
(678) 825-6030

Map and Direction




Provider's Profile

Full NameMrs Lisa Yvonne Bradshaw-small
GenderFemale
SpecialityNurse Practitioner - Family
Location6269 Greenock Dr, Stone Mountain, Georgia
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1043330301
  • Provider Enumeration Date: 03/30/2007
  • Last Update Date: 04/05/2012

Medical Identifiers

Medical identifiers for Mrs Lisa Yvonne Bradshaw-small such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043330301NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WP0809XRegistered Nurse - Psychiatric/mental Health, Adult RN141141 (Georgia)Secondary
363LF0000XNurse Practitioner - Family RN141141 (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 Yvonne Bradshaw-small is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Lisa Yvonne Bradshaw-small, APRN, BC
6269 Greenock Dr,
Stone Mountain, GA 30087-6081

Ph: (404) 819-9665
Mrs Lisa Yvonne Bradshaw-small, APRN, BC
6269 Greenock Dr,
Stone Mountain, GA 30087-6081

Ph: (404) 819-9665

Reviews and Comments


Nurse Practitioner Nurses in Stone Mountain, GA

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Phone: 770-322-6161    

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