| NPI | 1467747782 |
|---|---|
| Former Name | DACIA N JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A112574) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 112574) |
| 163W00000X Registered Nurse (Licence: MO 2005031446) | |
| 163W00000X Registered Nurse (Licence: CT 98660) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 04770) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A112574) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A-112574) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2022-03-17 |