Provider Demographics
NPI:1497401434
Name:JOHNSON, HANNAH LEIGH (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:LEIGH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5673 PEACHTREE DUNWOODY RD STE 675
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1774
Mailing Address - Country:US
Mailing Address - Phone:678-843-5408
Mailing Address - Fax:
Practice Address - Street 1:5673 PEACHTREE DUNWOODY ROAD
Practice Address - Street 2:SUITE 675
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1774
Practice Address - Country:US
Practice Address - Phone:678-843-5408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-28
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GANP000244207R00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner