Individual
JOHNNY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
110 FRANCIS ST, BOSTON, MA 02215-5501
(978) 677-8946
Mailing address
7 GOTHLAND ST, QUINCY, MA 02169-1821
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2351241
MA
Other
Enumeration date
02/27/2025
Last updated
05/25/2025
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