Individual
NANCY ELLEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 535-3611
(770) 535-7092
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 535-7445
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036403
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000532298N
—
GA
05
—
000532298P
—
GA
05
—
000532298Q
—
GA
05
—
000532298R
—
GA
05
—
000532298S
—
GA
01
—
10033001
AMERIGROUP
GA
01
—
1201604
UNITED HEALTHCARE
GA
01
—
302566
WELLCARE
GA
01
—
302576
WELLCARE
GA
01
—
302577
WELLCARE
GA
01
—
302578
WELLCARE
GA
01
—
317570
CIGNA
GA
01
—
4360675
AETNA
GA
01
—
52450432
BCBS
GA
Enumeration date
01/20/2006
Last updated
03/05/2019
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