Individual
SALLIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
194 WAGON WHEEL DR, REX, GA 30273-1444
(770) 389-0487
Mailing address
194 WAGON WHEEL DR, REX, GA 30273-1444
(770) 389-0487
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN12135
GA
Other
Enumeration date
06/14/2013
Last updated
06/14/2013
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