| NPI | 1861935058 |
|---|---|
| Former Name | CORTNEY JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: PA SP022853) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 86299) |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP017388) | |
| 363LF0000X Nurse Practitioner Family (Licence: WV APRN86299-NP-C) | |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2021-07-21 |