Individual
ANDREA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
444 N PLEASANT AVE, CENTRALIA, IL 62801-3006
(618) 436-5665
(618) 436-8042
Mailing address
1603 RUTH ANN DR, CENTRALIA, IL 62801-5913
(618) 214-1178
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.023676
IL
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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