Individual
ALICE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
200 NORTH ST, SUITE 101, GENEVA, NY 14456-1561
(315) 787-5100
(315) 787-5108
Mailing address
200 NORTH ST, SUITE 101, GENEVA, NY 14456-1561
(315) 787-5100
(315) 787-5108
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F330480
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01235432
—
NY
01
—
109570BJ
PREFERRED CARE
NY
01
—
P00003445
R.R. MEDICARE
NY
01
—
P019330480
BLUE CHOICE
NY
Enumeration date
12/21/2006
Last updated
07/08/2007
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