Johanne Dastine-Coriolan, NP
NPI #1063009470 in Loganville, Georgia
Provider Information
- NPI Number
- 1063009470
- Entity Type
- Individual
- Name
- Johanne Dastine-Coriolan, NP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Nurse Practitioner - Gerontology
- Credential
- NP
- Enumeration Date
- Dec 31, 2020
- Last Updated
- Dec 31, 2020
Practice Location
- Address
- 4344 GROVE LAKE ST
- City
- Loganville
- State
- Georgia
- ZIP Code
- 30052-8155
- Phone
- (770) 696-1350
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Gerontology — Gerontology |
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