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Individual

KEVIN MARK JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1170 CLEVELAND AVE, EAST POINT, GA 30344-3615
(404) 466-1249
Mailing address
106 CHERRY HILL LN, STOCKBRIDGE, GA 30281-7359
(770) 789-8956

Taxonomy

Speciality
Code
Description
License number
State
101YS0200X
School Counselor
363LF0000X
Family Nurse Practitioner
Primary
RN171627
GA

Other

Enumeration date
03/22/2022
Last updated
08/08/2025
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