Individual
MRS. MAE D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
914 VISTA DRIVE, DALTON, GA 30721-8654
(706) 226-3139
(706) 278-6606
Mailing address
914 VISTA DRIVE, DALTON, GA 30721-8654
(706) 226-3139
(706) 278-6606
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN027354
GA
363L00000X
Nurse Practitioner
Primary
RN027354
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000670326B
—
GA
Enumeration date
07/08/2005
Last updated
08/19/2024
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