Individual
JOHNNIE K CARRICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP
Contact information
Practice address
1 COLLEGE AVE RM 105, WISE, VA 24293-4400
(276) 376-3475
(376) 328-3102
Mailing address
1 COLLEGE AVE RM 105, WISE, VA 24293-4400
(276) 376-3476
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024175394
VA
Other
Enumeration date
03/26/2018
Last updated
01/30/2025
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