| NPI | 1013647452 |
|---|---|
| Former Name | TANASIA CHICOLE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11020179) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11020179) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F356962) | |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2026-04-02 |