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Individual

JASMINE NICOLE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
1015 TYRONE RD STE 420, TYRONE, GA 30290-2456
(470) 900-7361
Mailing address
1015 TYRONE RD STE 420, TYRONE, GA 30290-2456
(470) 900-7361

Taxonomy

Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary

Other

Enumeration date
03/27/2025
Last updated
03/27/2025
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