| NPI | 1578781951 |
|---|---|
| Former Name | SARA NAN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA C100940) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 100940) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2012-10-29 |