Johnson, Mae D
Johnson, Mae D is an individual health care provider with primary practice located at 1107 Memorial Dr Suite 300, Dalton GA 30720-8662. She recently has only one registered license in Nursing Service Providers / General Practice, which is considered as her primary health care specialty. Johnson, Mae D can be contacted via phone (706) 226-3139.Contact Information
Primary practice address
1107 Memorial Dr Suite 300
Dalton GA 30720-8662
Phone: (706) 226-3139
Fax: (706) 278-6606
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / General Practice | 163WG0000X | RN027354 | Georgia |
Profile Details
| NPI number | 1912905464 |
|---|---|
| LBN Legal business name | Johnson, Mae D |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2005 |
| Last updated | Dec 17th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912905464 | NPPES |
| Georgia | MEDICAID | 000670326B |
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