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NPI Code Detail

MEDICARE: RENEA DOUGHTON-JOHNSON NP

MEDICARE: RENEA DOUGHTON-JOHNSON NP
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
1363LF0000XFamily Nurse PractitionerRN072764GA

General Provider Information

NPI Number : 1780864793
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEA DOUGHTON-JOHNSON NP
Provider Business Mailing Address
First Line : 1520 AVENUE PL
Second Line :
City : ATLANTA
State : GA
Zip : 30329-4015
Country : US
Telephone Number : 404-639-5575
Fax Number :
Provider Business Practice Location Address
First Line : 1520 AVENUE PL
Second Line :
City : ATLANTA
State : GA
Zip : 30329-4015
Country : US
Telephone Number : 404-639-5575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2007
Last Update Date : 06/11/2021

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