| NPI | 1285026880 |
|---|---|
| Former Name | LISA ANN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WA 60534425) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA 95952) |
| Enumeration Date | 2015-02-19 |
| Last Update Date | 2015-02-19 |