NPI | 1881181634 |
---|---|
Former Name | KISHANA JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 28959) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018038756) |
163WE0003X Registered Nurse, Emergency (Licence: MO 2010010674) | |
Enumeration Date | 2018-04-17 |
Last Update Date | 2023-11-03 |