Individual
KANISHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN RN
Contact information
Practice address
6737 BILL CARRUTH PKWY APT 4311, HIRAM, GA 30141-3779
(770) 370-8088
Mailing address
6737 BILL CARRUTH PKWY APT 4311, HIRAM, GA 30141-3779
(770) 370-8088
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN256429
GA
163WG0000X
General Practice Registered Nurse
Primary
RN256429
GA
Other
Enumeration date
12/02/2021
Last updated
12/02/2021
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