NPI | 1790091700 |
---|---|
Former Name | KARA LYNN JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R-131129-3) |
Enumeration Date | 2010-08-27 |
Last Update Date | 2018-01-16 |