Johnson, Denetra
Johnson, Denetra is an individual health care provider with primary practice located at 5095 Mount Zion Pkwy , Stockbridge GA 30281-7825. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Johnson, Denetra can be contacted via phone (401) 652-9787.Contact Information
Primary practice address
5095 Mount Zion Pkwy
Stockbridge GA 30281-7825
Phone: (401) 652-9787
Fax: (401) 652-9787
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R865978 | Mississippi |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN161105 | Georgia |
Profile Details
| NPI number | 1205207388 |
|---|---|
| LBN Legal business name | Johnson, Denetra |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 14th, 2015 |
| Last updated | Oct 10th, 2025 - about last year |
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 | 1205207388 | NPPES |
| Georgia | Other | RN161105 | LICENSE |
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