Individual
RAE LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 LENTZ RD, MORRILTON, AR 72110-3740
(501) 354-1170
(501) 354-0095
Mailing address
1610 HIGHPOINT DR, CONWAY, AR 72034-6099
(501) 831-3023
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R29821
AR
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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