NPI | 1396090239 |
---|---|
Former Name | TAMERA LEE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 364SG0600X Clinical Nurse Specialist, Gerontology (Licence: OH 04494-NS) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704136194) |
364SG0600X Clinical Nurse Specialist, Gerontology (Licence: MI 4704136194) | |
364SM0705X Clinical Nurse Specialist, Medical-Surgical (Licence: OH 04494-NS) | |
Enumeration Date | 2012-07-17 |
Last Update Date | 2018-08-03 |