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Individual

JOHN LOUIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
3405 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 792-7021
Mailing address
4110 KNOLLCREST CIR N, MARTINEZ, GA 30907-1635
(706) 951-9216

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN283509
GA

Other

Enumeration date
08/23/2022
Last updated
08/23/2022
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