Provider Demographics
NPI:1366056764
Name:SORTO, LUCY GREER (NP)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:GREER
Last Name:SORTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3437 BIG LEAF CT
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4633
Mailing Address - Country:US
Mailing Address - Phone:678-936-0899
Mailing Address - Fax:
Practice Address - Street 1:3437 BIG LEAF CT
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-4633
Practice Address - Country:US
Practice Address - Phone:678-936-0899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA225994363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily