Provider Demographics
NPI:1922859628
Name:JOHNSON COTTON, VENICE GEVERNIA
Entity Type:Individual
Prefix:
First Name:VENICE
Middle Name:GEVERNIA
Last Name:JOHNSON COTTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 QUAIL HOLLOW TRL
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-4423
Mailing Address - Country:US
Mailing Address - Phone:619-753-0100
Mailing Address - Fax:
Practice Address - Street 1:3730 QUAIL HOLLOW TRL
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-4423
Practice Address - Country:US
Practice Address - Phone:619-753-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula