Individual
MR. JOHNNY KYLE HARDEMAN II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2819 RUSTICWOOD DR, SNELLVILLE, GA 30078-2849
(912) 541-4983
Mailing address
2819 RUSTICWOOD DR, SNELLVILLE, GA 30078-2849
(912) 541-4983
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
249198
GA
Other
Enumeration date
12/23/2022
Last updated
12/23/2022
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