Individual
NICOLE HEATHER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 WHITCHER ST NE STE 160, MARIETTA, GA 30060-1160
(470) 956-8276
(770) 795-9161
Mailing address
4305 OKLAHOMA WAY NW, KENNESAW, GA 30152-5434
(818) 641-8850
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
188988
GA
Other
Enumeration date
11/06/2018
Last updated
11/06/2018
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