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Individual
HEATHER JOHNSON
Active
Individual
HEATHER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209014879
IL
363L00000X
Nurse Practitioner
71005773A
IN
363LA2100X
Acute Care Nurse Practitioner
Primary
209014879
IL
363LA2100X
Acute Care Nurse Practitioner
71005773A
IN
Other
Enumeration date
10/12/2015
Last updated
01/04/2017
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