Individual
JUDY DELOIS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2114 EVERGREEN PL, PORTSMOUTH, VA 23704-5330
(757) 930-9222
Mailing address
2114 EVERGREEN PL, PORTSMOUTH, VA 23704-5330
(757) 930-9222
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
1401021473
VA
Other
Enumeration date
11/30/2018
Last updated
11/30/2018
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