| NPI | 1104562198 |
|---|---|
| Professional Name | KEISHA RENARDA JOHNSON-ROSEBORO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 26079) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-05-11 |