NPI age
2 years
Enumerated 2023-06-27
● Active Type 2 · Organization
Provenance Psychiatric Services Llc
Provenance Psychiatric Services Llc is 1 of 56 clinical nurse specialist organizations in Georgia.
Primary specialty
Clinical Nurse Specialist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Johnson
Owner
Last NPPES update
2025-03-19
Source: monthly bulk 2026-05
How this organization compares
Across 56 active clinical nurse specialist providers in Georgia.
NPI age
2 years
↓ 16 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2023 → 2026
2023-06Enumerated in NPPES
2023
2026
Where they practice
Primary practice location
643 Ray Lewis Rd
Blairsville, GA 305121439
Mailing address
643 Ray Lewis Rd
Blairsville, GA 305121439
Authorized official
Brian Kent Johnson, APRN
Owner
📞 6104531548
Specialties
-
Clinical Nurse Specialist PrimaryDefinition to come...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Provenance Psychiatry
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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