person
Johanne Dastine-coriolan, NP
Gerontology Nurse Practitioner in Loganville, Georgia
NPI 1063009470

Johanne Dastine-coriolan is a Gerontology Nurse Practitioner based in Loganville, GA and is specialized in Gerontology. Johanne Dastine-coriolan practices in Loganville, GA and has the professional credentials of NP. The NPI Number for Johanne Dastine-coriolan is 1063009470 and holds a License No. RN208229 (Georgia).

The current practice location address for Johanne Dastine-coriolan is 4344 Grove Lake St, Loganville, GA and can be reached out via phone at 770-696-1350.

Location: 4344 Grove Lake St, Loganville, GA, 30052-8155
person
Provider Profile Details
NPI Number
1063009470
Provider Name
Johanne Dastine-coriolan
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
4344 Grove Lake St, Loganville, GA, 30052-8155
Phone Number
770-696-1350
Fax Number
Provider Enumeration Date
12/31/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4344 Grove Lake St
City
State
Zip
30052-8155
Phone Number
770-696-1350
Fax Number
person
Provider Business Mailing Address Details
Address
4344 Grove Lake St
City
State
Zip
30052-8155
Phone Number
770-696-1350
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
License No.
RN208229 (Georgia)
Definition
Definition to come...
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