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Individual

MRS. BRENDA JOYCE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
600 N WOLFE STREET MEYER 6 113, BALTIMORE, MD 21287-0001
(410) 614-0522
Mailing address
600 N WOLFE STREET MEYER 6 113, BALTIMORE, MD 21287-0001
(410) 614-0522

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R102027
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NO NUMBER
Enumeration date
10/15/2009
Last updated
10/15/2009
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