NPI | 1578744462 |
---|---|
Former Name | SUSAN L JOHNSTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 3451491) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 141459) |
163WP0200X Registered Nurse, Pediatrics (Licence: NY 354149) | |
Enumeration Date | 2007-11-19 |
Last Update Date | 2012-01-05 |