Individual
MRS. SHERRY BLAKNEY-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
550 POPE AVENUE, UNITED STATES ARMY MEDICAL DEPARTMENT ACTIVITY, FORT LEAVENWORTH, KS 66027-2332
(999) 999-9999
Mailing address
9417 NORTH GOWER AVENUE, KANSAS CITY, MO 64154-1293
(972) 767-7472
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2010018119
MO
164W00000X
Licensed Practical Nurse
24-40168-081
KS
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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