Individual
MRS. RAEANNE TATEM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,MSN,CPNP-PC
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
20227375
NC
363LP0200X
Pediatric Nurse Practitioner
5007103
NC
Other
Enumeration date
08/19/2014
Last updated
07/11/2022
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