NPI | 1316121544 |
---|---|
Former Name | PATRICIA ANN JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 429852) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: FL 429852) |
Enumeration Date | 2007-12-24 |
Last Update Date | 2007-12-24 |