Individual
MARYGRACE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5115 80TH ST, LUBBOCK, TX 79424-3017
(806) 788-4368
(806) 788-4369
Mailing address
PO BOX 93128, LUBBOCK, TX 79493-3128
(880) 678-8438
(806) 788-4369
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP132557
TX
Other
Enumeration date
11/30/2016
Last updated
02/22/2021
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