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General NPI Number Information
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NPI Number | 1669394714
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Entity Type | Individual
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Provider Name | VENESA RICHARDS-JOHNSON APRN
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Gender | Female
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Dates
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Enumeration Date | 07/29/2026
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Last Update Date | 07/29/2026
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Provider Practice Location Address
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Address Line | 2395 WALL ST SE STE 180
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City | CONYERS
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State | GA
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Zip | 30013-6703
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Country | US
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Telephone | 770-809-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 1376 VILLAGE BROOK DR
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City | DACULA
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State | GA
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Zip | 30019-3500
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Country | US
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Telephone | 406-945-1021
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | GAA-NP005092
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License Number State | GA
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