Individual
MRS. VICKY LENETTE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2491 PANOLA RD, LITHONIA, GA 30058-4831
(678) 205-4999
Mailing address
1315 WILD ROSE DR SE, CONYERS, GA 30013-7444
(678) 852-5475
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN201739
GA
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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