Clayton State University
Organization Active NPI Family Nurse Practitioner · Morrow, GA
NPI 1659758985 · NPPES record last updated Dec 4, 2015
Key facts
- NPI
- 1659758985
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- CLAYTON STATE UNIVERSITY
- Practice address
- 5809 Northlake Drive
BLDG 1000
Morrow, GA 30260 - Phone
- (678) 466-5590
- Fax
- (678) 466-4999
- NPI assigned
- May 6, 2015
- Organization subpart
- No
Authorized official
- Name
- Betty Susan Lane, RN, PH.D., FNP-C
- Title
- Chair Nursing
- Phone
- (678) 466-4953
Practitioners 1
-
Betty Susan Lane, PHD, MSN, BSN, FNP
National Provider Directory
Locations
2000 Clayton State Blvd
Morrow, GA 30260
Phone (678) 466-4000
5809 N Lake Dr
Bldg 1000
Morrow, GA 30260
Phone (678) 466-4940
5809 N Lake Dr
#1000
Morrow, GA 30260
Phone (678) 466-5590
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
5809 Northlake Drive
BLDG 1000
Morrow, GA 30260
Mailing address
2000 Clayton State Blvd
Morrow, GA 30260
Other providers in Morrow, GA
- Clayton County Juvenile Justice Fund
- Clayton County Public Schools
- Clayton Mhddad
- Clayton Mhddad
- Clayton State University
- Clayton State University
- CLR Personal Home Care, LLC
- Angela E. Cochran
- Willie Cochran Jr.
- Cognitive Healing of Atlanta LLC
All providers in Morrow, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.