| NPI | 1255672960 |
|---|---|
| Former Name | LAURA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17481) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 154774) |
| 363L00000X Nurse Practitioner (Licence: TN APN17481) | |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2022-09-26 |