Individual
MRS. CARLETTA FAYE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
404 TAFT DR, PORTSMOUTH, VA 23701-4160
(757) 372-2033
Mailing address
404 TAFT DR, PORTSMOUTH, VA 23701-4160
(757) 372-2033
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
0001204119
VA
Other
Enumeration date
05/01/2011
Last updated
05/01/2011
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