Individual
THERESA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(904) 710-6949
(757) 388-3280
Mailing address
600 GRESHAM DRIVE, NORFOLK, VA 23507
(757) 388-3059
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024170927
VA
Other
Enumeration date
08/06/2013
Last updated
01/27/2015
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