| NPI | 1023345352 |
|---|---|
| Former Name | ANGELIA DENISE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 14695) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 14695) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 14695) | |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2023-10-11 |