NPI | 1801204193 |
---|---|
Former Name | ERICA R JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002496) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 2024088247) |
163W00000X Registered Nurse (Licence: FL 9556166) | |
Enumeration Date | 2014-07-30 |
Last Update Date | 2024-11-01 |