Individual
NICOLE DASHAWN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1485 SAINT GEORGE PL, CONYERS, GA 30012-7127
(770) 688-6382
Mailing address
1485 SAINT GEORGE PL, CONYERS, GA 30012-7127
(770) 688-6382
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CL0228566
FL
Other
Enumeration date
07/01/2021
Last updated
07/01/2021
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