Individual
RUBI JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2396
(678) 212-6343
Mailing address
1215 SUNHILL DR, LAWRENCEVILLE, GA 30043-6748
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN179370
GA
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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