Individual
KATHLEEN MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
605 E LOCUST AVE, VICTORIA, TX 77901-3933
(361) 572-4300
Mailing address
112 CHAMPLAIN ST, VICTORIA, TX 77905-3721
(843) 303-2147
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
1109163
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
1109163
TX
363LG0600X
Gerontology Nurse Practitioner
1109163
TX
Other
Enumeration date
01/30/2023
Last updated
01/30/2023
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