Doctor Name: | CLAUDETTE ANGELLA JOHNSON |
NPI Number: | 1306235312 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | RN180553 |
Business Practice Address: | 814 Arbor Way Loganville, GA - 300528028 |
Business Phone Number: | 6786152677 |
Business Fax Number: | |
Mailing Address: | 814 Arbor Way, LOGANVILLE |
State: | GA |
Postal Code: | 300528028 |
Phone Number: | 6786152677 |
Fax Number: | |
NPI Enumeration Date: | 01/13/2015 |
NPI Last Update Date: | 03/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN180553 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |