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Individual
JOHNNA FORMAN
Active
Individual
JOHNNA FORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
3011059
KY
363LP0200X
Pediatric Nurse Practitioner
3011059
KY
363LP0222X
Critical Care Pediatric Nurse Practitioner
3011059
KY
Other
Enumeration date
10/21/2015
Last updated
06/15/2023
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