JOHANNE DASTINE-CORIOLAN

LOGANVILLE, GA
NPI1063009470
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LG0600X Nurse Practitioner, Gerontology
(Licence: GA  RN208229)
Enumeration Date2020-12-31
Last Update Date2020-12-31
Business Address
JOHANNE DASTINE-CORIOLAN NP
4344 GROVE LAKE ST
LOGANVILLE, GA 30052-8155
Phone number: 770-696-1350
Mailing Address
JOHANNE DASTINE-CORIOLAN NP
4344 GROVE LAKE ST
LOGANVILLE, GA 30052-8155
Phone number: 770-696-1350