Individual
MICA K JOHNESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
3737 GOLDMAN ST, DALLAS, TX 75212-2471
(214) 266-0900
Mailing address
565 GRIFFITH DR, SAGINAW, TX 76179-0983
(325) 829-1844
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
AP135787
TX
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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