MEDICARE: CAROLINE ELIZABETH JOHNSON NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN275458	GA

General Provider Information

NPI Number	:	1225834328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE ELIZABETH JOHNSON NP-C

Provider Business Mailing Address
First Line	:	762 HIGHLAND AVE NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-1451
Country	:	US
Telephone Number	:	864-704-5287
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 KROG ST NE FL 4
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30307-2677
Country	:	US
Telephone Number	:	864-704-5287
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2025
Last Update Date	:	03/05/2025

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