Individual
EVA P. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 534-2020
(770) 534-8025
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN074598
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01188979
AMERIGROUP
GA
01
—
446578
WELLCARE
GA
05
—
739070228A
—
GA
05
—
891011560
—
AL
Enumeration date
06/08/2006
Last updated
12/08/2020
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