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Kaitlyn Anne Johnson

Pediatrics in Conyers, GA. Individual provider (NPI-1).

NPI number1346807641
StatusActive
Last updated in NPPESSep 22, 2022

Details

NPI
1346807641
Entity type
Individual (NPI-1)
Name
Kaitlyn Anne Johnson
Sex
Female
Sole proprietor
No
Enumeration date
May 22, 2019
Certification date
Sep 22, 2022
Last updated
Sep 22, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208000000X Pediatrics92287GAYes
390200000X Student in an Organized Health Care Education/Training Program0116032595VA

Practice location

1277 Wellbrook Cir Ne
Conyers, GA 30012

Phone 770-922-5745 · Fax 678-750-1406

Mailing address

1277 Wellbrook Cir Ne
Conyers, GA 30012

Phone 770-922-5745

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