| NPI | 1760201255 |
|---|---|
| Former Legal Business Name | NP JOHNSON TELEHEALTH WELLNESS CARE, LLC |
| Entity Type | Organization |
| Authorized Contact | DAMARIS LAVERNE JOHNSON Owner 314-520-8856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2024-10-10 |
| Last Update Date | 2024-10-10 |