| NPI | 1912418567 |
|---|---|
| Former Name | ANGELA SANDRA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: MN 5551) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: MN R153636-3) |
| Enumeration Date | 2017-10-21 |
| Last Update Date | 2019-09-03 |