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Individual

MS. LAURIE G. JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN

Contact information

Practice address
308 COLISEUM DR, SUITE 120, MACON, GA 31217-3808
(770) 496-9400
(770) 496-9495
Mailing address
1835 SAVOY DR, SUITE 300, ATLANTA, GA 30341-1072
(770) 496-9400
(770) 496-9495

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN101726
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103763417A
GA
Enumeration date
01/10/2006
Last updated
02/26/2008
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