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Individual

ZANDRA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
29 TIMBERLAND TRACE CT, DALLAS, GA 30157-9669
(470) 819-1138
Mailing address
PO BOX 1832, MABLETON, GA 30126-1013
(470) 819-1138

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
078395
GA

Other

Enumeration date
12/12/2022
Last updated
12/12/2022
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