Individual
MRS. PAMELA SUE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1115 HARBOR RD, GROVE, OK 74344-3505
(918) 786-4434
Mailing address
1115 HARBER ROAD, GROVE, OK 74344
(918) 786-4434
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0079207
OK
Other
Enumeration date
02/22/2016
Last updated
02/22/2016
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