Individual
LOLITA JONES-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3355 GEORGE BUSBEE PKWY NW, 724, KENNESAW, GA 30144-6823
(678) 502-0341
(770) 514-2803
Mailing address
3355 GEORGE BUSBEE PKWY NW, 724, KENNESAW, GA 30144-6823
(678) 502-0341
(770) 514-2803
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000734684E
—
GA
01
—
000734687E
PEACHSTATE PROVIDER #
GA
01
—
10047949
AMERIGROUP
GA
Enumeration date
12/22/2006
Last updated
06/04/2012
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