Individual
MRS. KATHLEEN MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
4650 W. SWEETWATER, GLND, AZ 85304
(602) 347-2600
(602) 347-2709
Mailing address
6026 W WILLOW AVE, GLENDALE, AZ 85304-1101
(623) 979-3480
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
RN033369
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
559114
—
AZ
Enumeration date
04/27/2007
Last updated
07/08/2007
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