IndividualActive
Jacqueline Johnson, M.DIV.
NPI 1750504353 · Addiction (Substance Use Disorder) Registered Nurse · Decatur, GA
Provider details
- NPI number
- 1750504353
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) Registered NurseNursing Service Providers
- Credential
- M.DIV.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 146319 (GA)
Specialties & taxonomies
Nursing Service Providers
Practice location
4425 Memorial Dr
Decatur, GA 30032-1337
Phone: (404) 298-8383
Approximate (ZIP-level) locationGet directions
Mailing address
764 Wynbrooke Pkwy
Stone Mountain, GA 30087-6322
Registry dates
- Enumerated
- 2007-04-11
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.