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1477742047
DAVID E JOHNSON
MARYVILLE, IL
NPI
1477742047
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209-004434)
Enumeration Date
2007-10-19
Last Update Date
2024-08-28
Business Address
DAVID E JOHNSON ANP
6812 STATE ROUTE 162 STE 21
MARYVILLE, IL 62062-8565
Phone number: 618-288-5566
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Mailing Address
DAVID E JOHNSON ANP
6810 STATE ROUTE 162 BOX 215
MARYVILLE, IL 62062-8501
Phone number: 618-391-6405
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