| NPI | 1366849069 |
|---|---|
| Other Name | THERESA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704285116) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704285116) |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2022-11-04 |