Individual
REGINA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1617 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4127
(336) 842-6980
(336) 842-6985
Mailing address
1617 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4127
(336) 842-6980
(336) 842-6985
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
74607
NC
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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