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Individual

JESSICA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGPCNP

Contact information

Practice address
615 E VILLANOW ST, LA FAYETTE, GA 30728-2618
(706) 638-1606
Mailing address
615 E VILLANOW ST, LA FAYETTE, GA 30728-2618
(706) 638-1606

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
37238
TN
363L00000X
Nurse Practitioner
Primary
RN294745
GA

Other

Enumeration date
12/24/2024
Last updated
06/14/2025
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