Provider Demographics
NPI:1174864110
Name:JOHNSON, ABBIE HOPE (PA-C)
Entity Type:Individual
Prefix:
First Name:ABBIE
Middle Name:HOPE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 HOWELL MILL RD NW
Mailing Address - Street 2:SUITE 175
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2538
Mailing Address - Country:US
Mailing Address - Phone:404-607-1777
Mailing Address - Fax:404-607-1799
Practice Address - Street 1:1800 HOWELL MILL RD NW
Practice Address - Street 2:SUITE 175
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2538
Practice Address - Country:US
Practice Address - Phone:404-607-1777
Practice Address - Fax:404-607-1799
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006257363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant