Individual
ALICE JEANETTE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
931 E NORTHFIELD BLVD, MURFREESBORO, TN 37130-1204
(615) 890-3471
Mailing address
931 E NORTHFIELD BLVD, MURFREESBORO, TN 37130-1204
(615) 890-3471
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0187930
BCBS
TN
05
—
1450521
—
TN
Enumeration date
01/09/2008
Last updated
01/09/2008
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