NPI | 1447687512 |
---|---|
Former Name | ANGELETTA MACHELLE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN116219) |
Enumeration Date | 2013-10-03 |
Last Update Date | 2023-07-12 |