Tamika Johnnicans, Nurse Practitioner
Nurse Practitioner, Family in Stockbridge, GA. Individual provider (NPI-1).
NPI number1982181640
StatusActive
Last updated in NPPESAug 17, 2018
Details
- NPI
- 1982181640
- Entity type
- Individual (NPI-1)
- Name
- Tamika Johnnicans
- Credential
- Nurse Practitioner
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 25, 2018
- Last updated
- Aug 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | RN209553 | GA | Yes |
Practice location
145 Eagles Walk Ste AStockbridge, GA 30281
Phone 770-914-1808 · Fax 770-914-6828
Mailing address
145 Eagles Walk Ste AStockbridge, GA 30281-7340
Phone 770-914-1808 · Fax 770-914-6828
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