Individual
LATREASIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1901 ELM PARK DR, HAMPTON, GA 30228-5519
(478) 737-5429
Mailing address
1901 ELM PARK DR, HAMPTON, GA 30228-5519
(478) 737-5429
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN085167
GA
Other
Enumeration date
01/26/2023
Last updated
01/26/2023
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