Individual
MARY R. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1629 WOODLAWN AVE, DYERSBURG, TN 38024-2025
(731) 285-7311
(731) 286-2527
Mailing address
1629 WOODLAWN, DYERSBURG, TN 38024
(731) 285-7311
(731) 286-2527
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0000111176
TN
Other
Enumeration date
02/15/2007
Last updated
07/08/2007
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