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JOHANNE DASTINE-CORIOLAN NP
NPI 1063009470
Nurse Practitioner - Gerontology in Loganville, GA

Active since December 31, 2020
4344 GROVE LAKE ST, LOGANVILLE, GA 30052(770) 696-1350 Get Directions Write a Review

NPPES record last updated: December 31, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Johanne Dastine-coriolan Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHANNE DASTINE-CORIOLAN NP (NPI 1063009470) is an individual gerontology provider in Loganville, Georgia, licensed in Georgia (RN208229) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1063009470
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameJOHANNE DASTINE-CORIOLANCredential: NP
Location Address4344 GROVE LAKE STLoganville, GA 30052-8155
Mailing Address4344 Grove Lake StLoganville, GA 30052-8155 · (770) 696-1350
Phone(770) 696-1350
Sole ProprietorYes
Enumeration DateDecember 31, 2020
NPPES CertifiedDecember 31, 2020
✔ NPI 1063009470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in GA · RN208229
4344 GROVE LAKE ST, Loganville, GA 30052
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Johanne Dastine-coriolan's NPI number?

The NPI number for Johanne Dastine-coriolan is 1063009470. It was assigned to this individual provider in the NPPES registry on December 31, 2020.

Where is Johanne Dastine-coriolan located?

Johanne Dastine-coriolan practices at 4344 Grove Lake St, Loganville, GA 30052. The listed phone number is (770) 696-1350.

What is Johanne Dastine-coriolan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

When was this NPI record last updated?

The NPPES record for Johanne Dastine-coriolan was last updated on December 31, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.