Individual
JANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
865 AUSTIN DR, DEMOREST, GA 30535-4513
(706) 754-8811
Mailing address
722 PLUM LN, CLARKESVILLE, GA 30523-1446
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN142265
GA
Other
Enumeration date
07/06/2017
Last updated
07/06/2017
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