| NPI | 1225052145 |
|---|---|
| Former Name | TIFFANY A JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP2400) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP2400) |
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00308500) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-10-25 |