Individual
KAITLYN ANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1277 WELLBROOK CIR NE, CONYERS, GA 30012
(770) 922-5745
(678) 750-1406
Mailing address
1277 WELLBROOK CIR NE, CONYERS, GA 30012
(770) 922-5745
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
92287
GA
390200000X
Student in an Organized Health Care Education/Training Program
0116032595
VA
Other
Enumeration date
05/22/2019
Last updated
09/22/2022
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