| NPI | 1023610318 |
|---|---|
| Former Name | ALYSSA DANIELLE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G173571) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2019001529) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2019040441) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2019040442) | |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2023-05-30 |