Individual
GEORGETTE R JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 RENAISSANCE CIR STE 1, MAULDIN, SC 29662-2459
(864) 907-7627
Mailing address
401 REVIS CREEK CT, SIMPSONVILLE, SC 29681-6339
(864) 907-7627
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
205384
SC
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/08/2024
Last updated
02/12/2024
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