NPI | 1609910686 |
---|---|
Former Name | KATHALEEN A JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP009142) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN516826L) |
363LF0000X Nurse Practitioner, Family (Licence: PA SP009142) | |
Enumeration Date | 2007-02-16 |
Last Update Date | 2019-03-21 |