Provider Demographics
NPI:1841747946
Name:AIELLO, LISA KIM (FNP-C, PMHNP-C)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:KIM
Last Name:AIELLO
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CABIN DR
Mailing Address - Street 2:
Mailing Address - City:HIAWASSEE
Mailing Address - State:GA
Mailing Address - Zip Code:30546-4895
Mailing Address - Country:US
Mailing Address - Phone:706-970-5431
Mailing Address - Fax:706-887-5608
Practice Address - Street 1:15 CABIN DR
Practice Address - Street 2:
Practice Address - City:HIAWASSEE
Practice Address - State:GA
Practice Address - Zip Code:30546-4895
Practice Address - Country:US
Practice Address - Phone:706-970-5431
Practice Address - Fax:706-896-1924
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN169588163W00000X, 363LP0808X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine