Individual
MRS. ANTONISE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1334 N LANSING AVE, TULSA, OK 74106-5907
(918) 587-2171
(918) 978-9077
Mailing address
PO BOX 929, CHICKASHA, OK 73023-0929
(405) 896-8058
(855) 223-1999
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
88183
OK
Other
Enumeration date
11/14/2018
Last updated
03/20/2023
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