MRS. LIZA NICOLE MASSEY (NPI# 1255623575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255623575 |
| Entity Type | Individual |
| Full Name | MRS. LIZA NICOLE MASSEY |
| Other Name | LIZA NICOLE GILFORD |
| Credential | PNP-C |
| Practice Address |
4112 E Ponce De Leon Ave Clarkston GA 30021-8106 |
| Practice Telephone | 4042967133 |
| Practice Fax Number | 4042967211 |
| Mailing Telephone | 4042967133 |
| Mailing Fax Number | 4042967211 |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2017-01-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN133970 | GA | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | RN133970 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4112 E PONCE DE LEON AVE |
| City | CLARKSTON |
| State | GA |
| Zip Code | 30021-8106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366441032 | Patrice Gibson Chishom | Pediatrics | 4112 E Ponce De Leon Ave, Clarkston, GA 30021-8106 | 2005-07-15 |
| 1962038307 | Thanmayie Bethi | Nurse Practitioner | 4112 E Ponce De Leon Ave, Clarkston, GA 30021-8106 | 2020-03-17 |
| 1285278739 | Emily Schober Klingman | Registered Nurse | 4112 E Ponce De Leon Ave, Clarkston, GA 30021-8106 | 2019-10-28 |
| 1376081448 | Marlena Sherman | Nurse Practitioner | 4112 E Ponce De Leon Ave, Clarkston, GA 30021-8106 | 2017-02-08 |
| 1043690605 | Andrea Zmaj | Nurse Practitioner | 4112 E Ponce De Leon Ave, Clarkston, GA 30021-8106 | 2015-06-08 |
| 1548568785 | Erica Mercedes Walker | Nurse Practitioner | 4112 E Ponce De Leon Ave, Clarkston, GA 30021-8106 | 2011-03-12 |
| 1619029592 | Decatur Pediatric Group, Pa | Pediatrics | 4112 E Ponce De Leon Ave, Clarkston, GA 30021-1817 | 2007-01-18 |
| 1962579631 | Keanna L Joseph-clarke | Pediatrics | 4112 E Ponce De Leon Ave, Clarkston, GA 30021-8106 | 2006-11-29 |
| 1275549388 | Kimberly M Humphrey-browne | Pediatrics | 4112 E Ponce De Leon Ave, Clarkston, GA 30021-1817 | 2006-07-31 |
| 1205841046 | Shyronda Yvette Pleasant | Pediatrics | 4112 E Ponce De Leon Ave, Clarkston, GA 30021-8106 | 2006-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578081808 | Marqueta A Coffer | Case Manager/Care Coordinator | 1380 Brockett Pl, Clarkston, GA 30021 | 2017-09-07 |
| 1063965143 | Bertukan Worku Demas | Pharmacist | 3671 Cobble Mill Ln, Clarkston, GA 30021 | 2016-07-26 |
| 1912341967 | Esther Kim | Family Medicine | 887 N Indian Creek Dr Ste A, Clarkston, GA 30021 | 2013-04-22 |
| 1265739437 | Carepoint Home Care, LLC | In Home Supportive Care | 4122 E Ponce Deleon Avenue, Unit 9, Clarkston, GA 30021 | 2011-02-23 |
| 1790956530 | Thu D. Vu | Dentist | 3596 Hill Street, Clarkston, GA 30021 | 2008-03-20 |
| 1740310630 | Gentle Dental | Dentist | 3595 Hill St., Clarkston, GA 30021 | 2007-03-07 |
| 1679528491 | Ojoru Osunkoya | Pediatrics | 4112 E. Ponce De Leon, Clarkston, GA 30021 | 2006-05-23 |
| 1700849825 | Regina Allen Hardin | Pediatrics | 4112 E. Ponce De Leon Avenue, Clarkston, GA 30021 | 2006-04-10 |
| 1831514538 | Caudelle & Wilson Eye Care LLC | Optometrist | 320 N Jeff Davis Drive, Suite A, Fayetteville, GA 30021 | 2014-03-04 |
| 1881865624 | Vanessa Phan | Dentist | 3596 Hill Street, Clarkston, GA 30021 | 2008-03-20 |
| Find all providers in zip 30021 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114536232 | Suzanne Marie Lugger | Nurse Practitioner | 5028 Ridge Trl S, Clarkston, MI 48348-2180 | 2020-07-24 |
| 1487295531 | Mick Allen Brown | Nurse Practitioner | 1226 Highland Ave, Clarkston, WA 99403-2830 | 2019-09-30 |
| 1083978837 | Jennifer Lynn Nicholas | Nurse Practitioner | 1433 5th St, Clarkston, WA 99403-2714 | 2012-06-26 |
| 1275779308 | Danette Florene Hanson | Nurse Practitioner | 10350 Dartmouth Rd, Clarkston, MI 48348-2115 | 2008-12-18 |
| 1750405767 | Jennifer Altmiller Kaufman | Nurse Practitioner | 302 5th St, Ste 3, Clarkston, WA 99403 | 2007-03-16 |
| 1295840270 | Carol Chandler | Nurse Practitioner | 808 Port Dr, Clarkston, WA 99403-6009 | 2006-08-20 |
| 1427161751 | Eve Kehrer | Nurse Practitioner | 7192 N Main St, Clarkston, MI 48346-1571 | 2006-08-17 |
| 1639242597 | Kristie Koczenasz | Nurse Practitioner | 5701 Bow Pointe Dr, Suite 280, Clarkston, MI 48346-3198 | 2006-11-16 |
| 1588772461 | Jennifer C Creaser | Nurse Practitioner | 1221 Highland Ave, Clarkston, WA 99403-2829 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841186 | Cynthia Marie Benjamin Bates | Nurse Practitioner | 2746 Willis Foreman Rd, Hephzibah, GA 30815-6935 | 2020-11-06 |
| 1841891199 | Gloria Oduro | Nurse Practitioner | 983 Bentley Estates Dr, Dacula, GA 30019-7795 | 2020-11-03 |
| 1689274094 | Shundria Brown | Nurse Practitioner | 2122 Ellwyn Dr, Chamblee, GA 30341-1520 | 2020-10-27 |
| 1629677455 | Amy Lynn Patterson | Nurse Practitioner | 254 Senna St, Marietta, GA 30064-4417 | 2020-10-22 |
| 1538768965 | Tabitha Ford | Nurse Practitioner | 110 Shorter St Lot 9, Ty Ty, GA 31795-3179 | 2020-10-16 |
| 1902404320 | Shanelle Lynette Raiford | Nurse Practitioner | 2028 Hidden Meadow Ln, Stone Mountain, GA 30088-4448 | 2020-10-16 |
| 1760089072 | Diana Maresi Bulimu | Nurse Practitioner | 6050 Peachtree Pkwy # 240-178, Norcross, GA 30092-3336 | 2020-10-08 |
| 1760089692 | Natalie Xiomara Leak | Nurse Practitioner | 4855 Chesterfield Ct, Suwanee, GA 30024-1350 | 2020-10-05 |
| 1548877723 | Camille Watson-clarke | Nurse Practitioner | 3650 Steve Reynolds Blvd Ste 316, Duluth, GA 30096-4506 | 2020-09-30 |
| 1801403654 | Jacqueline Richart | Nurse Practitioner | 6300 Hospital Pkwy Ste 260, Johns Creek, GA 30097-1829 | 2020-09-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.