Individual ProviderHanna Lee ParkNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address11459 Johns Creek Pkwy Ste 250, Johns Creek, GA 30097-3517(770) 497-1555PECOS EnrollmentBased on the most recent information from CMS, provider Hanna Lee Park does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 9:24 AM.Profile DetailsProvider ID1538553623Provider TypeIndividualFull NamePark, Hanna LeeTitleMrs.CredentialFNP-CGenderFemaleSole ProprietorNoEnumeration Date3/26/2015Last Updated3/27/2015Contact InformationPractice LocationPractice Address11459 Johns Creek Pkwy Ste 250, Johns Creek, GA 30097-3517Phone(770) 497-1555Fax(770) 497-9998Mailing LocationMailing Address11459 Johns Creek Pkwy, Johns Creek, GA 30097-3515PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN205794Georgia