Individual
MRS. RATANA LENELL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
38 WHIPPLE RD, SOUTH HERO, VT 05486-4900
(802) 372-4020
Mailing address
21 LAPIERRE DRIVE, MILTON, VT 05468
(802) 893-6368
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
025-0006939
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007424
—
VT
Enumeration date
02/21/2007
Last updated
07/09/2007
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