Individual
TANELL TWANNA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 PALMYRA RD, ALBANY, GA 31701-1320
(298) 883-3636
(229) 888-5535
Mailing address
204 N WESTOVER BLVD, ALBANY, GA 31707-2983
(229) 888-6559
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN191184
GA
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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