| NPI | 1013162981 |
|---|---|
| Former Name | CRYSTAL C JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5903703-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1418A) |
| 363LF0000X Nurse Practitioner, Family (Licence: NV APRN001888) | |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2025-09-02 |