Individual
SUSAN F JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
301 UNIVERSITY BLVD, ROUTE 0479, GALVESTON, TX 77555-5302
(409) 772-1430
(409) 772-6833
Mailing address
301 UNIVERSITY BOULEVARD, 301 UNIVERSITY BLVD RT. 0479, GALVESTON, TX 77550-0479
(409) 772-1430
(409) 772-6833
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
232242
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155953602
—
TX
01
—
8N3649
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/11/2006
Last updated
03/18/2010
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