Individual
MIATTA LASSANAH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1557 BUFORD DRIVE, P.O.BOX 492994, LAWRENCEVILLE, GA 30043
(470) 305-3899
Mailing address
1557 BUFORD DRIVE, P.O.BOX 492994, LAWRENCEVILLE, GA 30043
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN259964
GA
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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