Individual
DIERA SHINAY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1609 NORMAN DR STE A, VALDOSTA, GA 31601-3753
(229) 262-3149
Mailing address
515 BARNSIDE LN, HAHIRA, GA 31632-1579
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN-NP305541
GA
Other
Enumeration date
10/06/2025
Last updated
12/08/2025
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