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Individual

TANISHA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2357 W MASON ST, GREEN BAY, WI 54303-4708
(920) 337-6740
Mailing address
9009 CAROTHERS PKWY STE C1, FRANKLIN, TN 37067-1704
(615) 538-7739

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
326698
WI

Other

Enumeration date
11/15/2024
Last updated
11/18/2024
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