| NPI | 1174913487 |
|---|---|
| Former Name | ANDREA SHAE CROW JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008804) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7785) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2023-11-30 |