| NPI | 1144790296 |
|---|---|
| Former Name | COURTNEY JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71008829A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3012889) |
| 363L00000X Nurse Practitioner (Licence: KY 3012889) | |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2022-03-07 |