Individual
MRS. CORELLA JAMES-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6600 VAN AALST BLVD, FORT BENNING, GA 31905-2102
(762) 408-2273
Mailing address
1014 SILVER LAKE DR, COLUMBUS, GA 31904-2709
(706) 580-3987
(762) 408-8119
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003337
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
964228085A
—
GA
05
—
964228085C
—
GA
Enumeration date
07/11/2006
Last updated
03/16/2023
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