Individual
ANGELA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27A DOWSING AVENUE, BAYSHORE, NY 11706-6013
(770) 899-2226
Mailing address
27A DOWSING AVE, BAY SHORE, NY 11706-4118
(770) 899-2226
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
284163-1
NY
164W00000X
Licensed Practical Nurse
Primary
LPN072931
GA
Other
Enumeration date
01/08/2014
Last updated
03/25/2014
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