IndividualActive
Alicia Johnson
NPI 1639535503 · Psychiatric/Mental Health Nurse Practitioner · Kennesaw, GA
Provider details
- NPI number
- 1639535503
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 211280 (ME)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1300 Ridenour Blvd Nw Ste 106
Kennesaw, GA 30152-4528
Phone: (470) 315-0055
Fax: (470) 464-7070
Approximate (ZIP-level) locationGet directions
Mailing address
1300 Ridenour Blvd Nw Ste 106
Kennesaw, GA 30152-4528
Registry dates
- Enumerated
- 2016-01-07
- Last updated
- 2025-07-15
- Certified
- 2025-07-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.