NPI | 1093823361 |
---|---|
Former Name | JILL JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F404957) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F351891) |
363LF0000X Nurse Practitioner, Family (Licence: TX 676803) | |
Enumeration Date | 2006-08-28 |
Last Update Date | 2024-09-24 |