Individual
WHITNEY LASHELL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 STONEBRIDGE CIR APT 1536, LITTLE ROCK, AR 72223-4550
(501) 358-9234
Mailing address
4055 VALLEY VIEW LN STE 400, DALLAS, TX 75244-5071
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A006194
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
926813107
DRIVERS LICENSE
AR
Enumeration date
08/13/2019
Last updated
08/13/2019
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