| NPI | 1043569437 |
|---|---|
| Former Name | KIMBERLY A JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 66267) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201505347NP-PP) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2024-04-24 |