Individual
KONICA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 LANGSTON DR, FORT PIERCE, FL 34946-1613
(772) 259-9514
Mailing address
3001 LANGSTON DR, FORT PIERCE, FL 34946-1613
(772) 259-9514
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
428447
FL
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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