Individual
MRS. BEVERLY R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
1186 KING ST, RYE BROOK, NY 10573-1069
(914) 946-4781
(914) 947-0117
Mailing address
1186 KING ST, RYE BROOK, NY 10573-1069
(914) 946-4781
(914) 947-0117
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
261393
NY
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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