Individual
MALLORY HARRIS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3100 KEMBLE AVE, BRUNSWICK, GA 31520-4211
(334) 279-1450
(334) 279-1660
Mailing address
PO BOX 116111, ATLANTA, GA 30368-6111
(334) 279-1450
(334) 279-1660
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN239579
GA
Other
Enumeration date
02/25/2019
Last updated
08/29/2023
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