| 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 |