| NPI | 1649201161 |
|---|---|
| Former Name | TAMMIE JEAN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R155408-9) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R155408-9) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2018-04-11 |