Individual
TAMMY MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1 EDMUNDSON PL STE 100, COUNCIL BLUFFS, IA 51503-4659
(717) 322-4136
(717) 322-8129
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(239) 432-8331
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A170098
IA
363LF0000X
Family Nurse Practitioner
A170098
IA
Other
Enumeration date
07/19/2022
Last updated
04/20/2023
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