| NPI | 1619553948 |
|---|---|
| Former Name | MICHAELLA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71011780A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704376360) |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2024-09-16 |