Individual
CAMILLE M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5230 DALLAS HWY, POWDER SPRINGS, GA 30127-4263
(404) 948-3019
Mailing address
1201 CAROLINA AVE, WASHINGTON, NC 27889-3571
(252) 975-1111
(252) 975-6696
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RN3105332
GA
363L00000X
Nurse Practitioner
Primary
RN3105332
GA
363LF0000X
Family Nurse Practitioner
201599
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811049448
—
NC
Enumeration date
01/16/2007
Last updated
06/06/2023
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