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General NPI Number Information
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NPI Number | 1639535503
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Entity Type | Individual
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Provider Name | DR. ALICIA KAY JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 01/07/2016
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 1300 RIDENOUR BLVD NW STE 106
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City | KENNESAW
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State | GA
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Zip | 30152-4528
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Country | US
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Telephone | 470-315-0055
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Fax | 470-464-7070
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Provider Business Mailing Address
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Address Line | 1300 RIDENOUR BLVD NW STE 106
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City | KENNESAW
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State | GA
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Zip | 30152-4528
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Country | US
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Telephone | 470-315-0055
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Fax | 470-464-7070
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 211280
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11723625-4405
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 20210293NP-PP
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN02540
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License Number State | RI
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 855120
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License Number State | NV
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 101.0135557TELE
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License Number State | VT
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 67513
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License Number State | ID
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Taxonomy #8
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 086000-23
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License Number State | NH
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Taxonomy #9
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN216448
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License Number State | GA
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Taxonomy #10
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 216448
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License Number State | GA
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