Provider Demographics
NPI:1669834461
Name:JOHNSON, MELANIE LENA (PA-C)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:LENA
Last Name:JOHNSON
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Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1470
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2212
Mailing Address - Country:US
Mailing Address - Phone:404-589-2670
Mailing Address - Fax:404-589-2671
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1470
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2212
Practice Address - Country:US
Practice Address - Phone:404-589-2670
Practice Address - Fax:404-589-2671
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2023-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA7910363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant