Individual
IFEOLUWA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(478) 777-7497
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN293073
GA
Other
Enumeration date
05/31/2025
Last updated
07/22/2025
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