Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marianne Lissade, AGNP-C

Individual provider Gerontology Nurse Practitioner · NPI 1780036152

Marianne Lissade, AGNP-C is a Nurse Practitioner in Stone Mountain, Georgia. Qualified in 2016, 10 years ago. Practices with Center for Pan Asian Community Services, Inc, a 2-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
10
Licensed in
GA
In the registry since
2016
Specialties on file
2

Practice location Address checks out

1825 Rockbridge Rd Ste 15B
Stone Mountain, GA 30087-3306
Phone: (470) 444-3134
Fax: (470) 276-4370
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 133 W Athens St, Winder, GA 30680-1786 — (770) 867-6633

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence RN147281 (GA)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence RN147281 (GA)

Record details

NPI number1780036152
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-C
Sole proprietorNo
NPI enumeratedJuly 8, 2016
Last updated in NPPESJanuary 22, 2024
Certification dateJanuary 22, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Center For Pan Asian Community Services, Inc. — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Stone Mountain