Individual
JOHNETTA TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
950 LANEY WALKER BLVD, AUGUSTA, GA 30901-2960
(706) 721-5900
Mailing address
3407 DANVERS AVE, AUGUSTA, GA 30906-5172
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
RN14321
GA
Other
Enumeration date
12/10/2010
Last updated
12/10/2010
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