Individual
AMILLIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 DORRANCE ST, PROVIDENCE, RI 02903-2018
(401) 206-4551
Mailing address
54 HILLSIDE AVE UNIT 201, TIVERTON, RI 02878-4646
(401) 206-4551
(877) 573-2230
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN102196
RI
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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