Provider Demographics
NPI:1215299953
Name:MCNEILL, ELIZABETH K (PA)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:K
Last Name:MCNEILL
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Gender:F
Credentials:PA
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Mailing Address - Street 1:531 ROSELANE ST NW
Mailing Address - Street 2:SUITE 710
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6913
Mailing Address - Country:US
Mailing Address - Phone:678-331-3302
Mailing Address - Fax:678-581-7187
Practice Address - Street 1:340 KENNESTONE HOSPITAL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1152
Practice Address - Country:US
Practice Address - Phone:770-281-5100
Practice Address - Fax:678-581-7100
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2013-12-18
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Provider Licenses
StateLicense IDTaxonomies
GA006502363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1215299953OtherNPI NUMBER