Individual
MINA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
369 WASHINGTON AVE, KINGSTON, NY 12401-3701
(917) 539-0810
Mailing address
369 WASHINGTON AVENUE, KINGSTON, NY 12401-3701
(914) 401-0008
(914) 401-0009
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
720423-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402418
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F402418-1
NY
Other
Enumeration date
06/27/2017
Last updated
03/13/2024
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