Individual
MRS. LYDIA ZIMMER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
5613 DURALEIGH RD, SUITE 101, RALEIGH, NC 27612-2694
(919) 782-4597
(919) 784-0089
Mailing address
5613 DURALEIGH RD, SUITE 101, RALEIGH, NC 27612-2694
(919) 782-4597
(919) 784-0089
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
261954
NC
363L00000X
Nurse Practitioner
Primary
5011443
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5011443
NC
Other
Enumeration date
04/14/2014
Last updated
09/19/2024
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