| NPI | 1730607672 |
|---|---|
| Former Name | HOLLI KERVIN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 28838) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 00000000000000) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 23571) | |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2024-10-28 |