| NPI | 1699143347 |
|---|---|
| Former Name | LAKESHA TULLIS JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-144132) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN193416) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2023-06-26 |