| NPI | 1538813167 |
|---|---|
| Former Name | JODI JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: WA AP61166144) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN61166141) |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2022-07-25 |