| NPI | 1093189623 |
|---|---|
| Former Name | STEPHANIE ANN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: MO 2010021417) |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |