Provider Demographics
NPI:1366053431
Name:LLOYD, JERI WELLS (NP-C)
Entity type:Individual
Prefix:
First Name:JERI
Middle Name:WELLS
Last Name:LLOYD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 BISHOPS WALK
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9295
Mailing Address - Country:US
Mailing Address - Phone:770-364-4490
Mailing Address - Fax:
Practice Address - Street 1:3030 OLD ATLANTA RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6939
Practice Address - Country:US
Practice Address - Phone:770-203-2000
Practice Address - Fax:770-886-7903
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2021-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN245628363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty