Individual
LADALE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 355-8620
(580) 250-5252
Mailing address
8026 WOODCHUCK RD, YUKON, OK 73099-8472
(405) 350-6965
(405) 350-6965
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
R51245
OK
Other
Enumeration date
08/04/2014
Last updated
08/04/2014
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