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Individual

MR. TRACY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
120 DANVILLE DR, LEESBURG, GA 31763-5706
(229) 308-6770
Mailing address
120 DANVILLE DR, LEESBURG, GA 31763-5706
(229) 308-6770

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN213578
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN213578
GA

Other

Enumeration date
06/22/2014
Last updated
01/12/2026
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