NPI | 1528110889 |
---|---|
Former Name | JILL R JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 642707) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 642707) |
Enumeration Date | 2007-01-17 |
Last Update Date | 2010-08-23 |