Individual
JAY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6400 UPTOWN BLVD NE, STE 360W, ALBUQUERQUE, NM 87110-4204
(505) 855-9805
(505) 848-9468
Mailing address
6400 UPTOWN BLVD NE, STE 360W, ALBUQUERQUE, NM 87110-4204
(505) 855-9805
(505) 848-9468
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R-60117
NM
Other
Enumeration date
02/20/2014
Last updated
02/20/2014
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