| NPI | 1861472243 |
|---|---|
| Former Name | JANESSA B JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3004257) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4257P) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2017-07-18 |