VERSIE JOHNSON-MALLARD

TAMPA, FL
NPI1245457829
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: FL  ARNP1949272)
Enumeration Date2007-04-18
Last Update Date2007-07-08
Business Address
-- VERSIE JOHNSON-MALLARD NP
12901 BRUCE B DOWNS BLVD # 22
TAMPA, FL 33612-4742
Phone number: 813-974-7210
Mailing Address
-- VERSIE JOHNSON-MALLARD NP
3292 HAWKS RIDGE DR
LAKELAND, FL 33810-4010
Phone number: 863-815-1675
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