Individual
DERILYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
670 W FIREWEED LN STE 160, ANCHORAGE, AK 99503-2561
(907) 770-0862
Mailing address
553 N ROBIN CIR APT 1A, WASILLA, AK 99654-6848
(907) 229-4145
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
NURP7072
AK
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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