Individual
KENZIE NICOLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1222 10TH ST, WOODWARD, OK 73801-3156
(580) 256-8615
Mailing address
2221 RED CEDAR, WOODWARD, OK 73801-6303
(918) 290-9877
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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