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Contact Information

ELISHIA K CRUMWELL MACK, CNP
301 PHILIP BLVD STE A
LAWRENCEVILLE, GA30046-8746
 Phone: 770-822-5560
 Fax: 770-822-4989
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for ELISHIA K CRUMWELL MACK · (Female)

NPI Number 1144863051
Status Active
Credentials CNP (Certified Nurse Practitioner)
Entity Individual
Enumeration date 10/23/2019
Last updated 10/09/2025 - About 8 months ago
Sole proprietor 1 No
Identifiers
  • GA License # RN302384
Hospital affiliation(s)
  • NORTH SHORE UNIVERSITY HOSPITAL - (Acute Care)
    300 COMMUNITY DRIVE
    MANHASSET, NY 11030
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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