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1376106971
ODETTE S JOHNSON
MONROE, CT
NPI
1376106971
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CT 8169)
Enumeration Date
2019-04-18
Last Update Date
2019-04-18
Business Address
ODETTE S JOHNSON APRN
324 ELM ST STE 202B
MONROE, CT 06468-2284
Phone number: 203-880-5335
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Mailing Address
ODETTE S JOHNSON APRN
71 ATWATER AVE
DERBY, CT 06418-1409
Phone number: 203-455-1545
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