Provider Demographics
NPI:1255709317
Name:LASSITER, LARRY MICHAEL (DNP, AGACNP-BC)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:MICHAEL
Last Name:LASSITER
Suffix:
Gender:M
Credentials:DNP, AGACNP-BC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:95 COLLIER RD NW
Mailing Address - Street 2:SUITE 2055
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1796
Mailing Address - Country:US
Mailing Address - Phone:404-605-2800
Mailing Address - Fax:404-351-5983
Practice Address - Street 1:95 COLLIER RD NW
Practice Address - Street 2:SUITE 2055
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1796
Practice Address - Country:US
Practice Address - Phone:404-605-2800
Practice Address - Fax:404-351-5983
Is Sole Proprietor?:No
Enumeration Date:2015-09-07
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN213223363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care