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Individual

CAROLYN JO JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, PMHNP

Contact information

Practice address
107 DILWORTH ST, GLENDIVE, MT 59330-2053
(307) 762-9999
Mailing address
107 DILWORTH ST, GLENDIVE, MT 59330-2053
(307) 762-9999

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
108044
MT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
22618.1145
WY

Other

Enumeration date
01/19/2012
Last updated
07/21/2022
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