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LISA M WALLER PAC
NPI 1851325831
Physician Assistant - Medical in Atlanta, GA

Active since July 10, 2006
1100 LAKE HEARN DRIVE, STE #450, ATLANTA, GA 30342(404) 252-7339(404) 257-0337 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lisa M Waller Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA M WALLER PAC (NPI 1851325831) is an individual medical provider in Atlanta, Georgia, licensed in New Hampshire (004516) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1851325831
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameLISA M WALLERCredential: PAC
Location Address1100 LAKE HEARN DRIVE, STE #450Atlanta, GA 30342
Mailing Address1100 Lake Hearn Drive, Ste 450Atlanta, GA 30342 · (404) 252-7339 · Fax (404) 257-0337
Phone(404) 252-7339
Fax(404) 257-0337
Sole ProprietorNo
Enumeration DateJuly 10, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1851325831 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NH · 004516
1100 LAKE HEARN DRIVE, Atlanta, GA 30342
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CATHERINE R BOMAR CPNP
Nurse Practitioner (Pediatrics)
1100 LAKE HEARN DRIVE, STE 450
ATLANTA, GA 30342
Fulton County (404) 252-7339

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Waller's NPI number?

The NPI number for Lisa Waller is 1851325831. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Where is Lisa Waller located?

Lisa Waller practices at 1100 Lake Hearn Drive Ste #450, Atlanta, GA 30342. The listed phone number is (404) 252-7339.

What is Lisa Waller's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Lisa Waller was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.