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Individual

MR. JOHN LEE STANTON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGPCNP-BC, APRN

Contact information

Practice address
3350 BRECKINRIDGE BLVD STE 200, DULUTH, GA 30096-4959
(770) 962-8396
(678) 990-6429
Mailing address
819 HIGHLAND GREEN WAY NE, ATLANTA, GA 30306-5212
(678) 522-3224

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN272616
GA
363LA2200X
Adult Health Nurse Practitioner
RN272616
GA
363LG0600X
Gerontology Nurse Practitioner
RN272616
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN272616
GA

Other

Enumeration date
03/19/2019
Last updated
03/19/2019
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