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1275142077
DETRA JOHNSON
LUBBOCK, TX
NPI
1275142077
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: TX 886175)
Enumeration Date
2020-07-28
Last Update Date
2020-07-28
Business Address
DETRA JOHNSON RN
7510 102ND ST
LUBBOCK, TX 79424-6882
Phone number: 806-790-0657
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Mailing Address
DETRA JOHNSON RN
3708 20TH ST STE A
LUBBOCK, TX 79410-1228
Phone number:
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