Individual
MS. ANDRAES N JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4130 MICHAEL PL, HEPHZIBAH, GA 30815-5937
(706) 589-6667
Mailing address
4902 LUTON DR, GROVETOWN, GA 30813-2237
(706) 589-6667
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN63232
GA
164X00000X
Licensed Vocational Nurse
062322
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN63232
GEORGIA NURSING BOARD
GA
Enumeration date
03/03/2013
Last updated
09/12/2024
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