Individual
THERESA ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, MSHSA, PA-C
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
(404) 417-1525
Mailing address
4419 CHERIE GLEN TRL, STONE MOUNTAIN, GA 30083-1825
(305) 733-9887
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-01038
NC
363A00000X
Physician Assistant
1719
FL
Other
Enumeration date
05/28/2008
Last updated
05/21/2022
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