Basic Information
| Provider Information | |||||||||
| NPI: | 1871059097 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOHNSON | ||||||||
| FirstName: | TONI | ||||||||
| MiddleName: | MCCALISTER | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1800 HOWELL MILL RD NW | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303182538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043509853 | ||||||||
| FaxNumber: | 4043508407 | ||||||||
| Practice Location | |||||||||
| Address1: | 1240 EAGLES LANDING PKWY STE 240 | ||||||||
| Address2: | |||||||||
| City: | STOCKBRIDGE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302815173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788549500 | ||||||||
| FaxNumber: | 6788549502 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2019 | ||||||||
| LastUpdateDate: | 02/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN298876 | GA | N | Nursing Service Providers | Registered Nurse | 163WX0200X | RN148797 | LA | N | Nursing Service Providers | Registered Nurse | Oncology | 363L00000X | RN298876 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.