Provider Demographics
NPI:1609751635
Name:JOHNSON, JOHNAY (RN)
Entity type:Individual
Prefix:
First Name:JOHNAY
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 BUTTERNUT DR
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-0350
Mailing Address - Country:US
Mailing Address - Phone:706-831-7451
Mailing Address - Fax:
Practice Address - Street 1:1822 BUTTERNUT DR
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-0350
Practice Address - Country:US
Practice Address - Phone:706-831-7451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN3235062084P0804X, 364SP0812X, 163WP0807X, 163WC1500X, 163WI0500X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No364SP0812XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Community
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult