| NPI | 1437519519 |
|---|---|
| Former Name | CARRIE ELIZABETH JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3010091) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010091) |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2022-09-08 |