Individual
MICHELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
300B PRESTIGE PARK DR, HURRICANE, WV 25526-8419
(304) 202-3864
Mailing address
364 HAILEY LN, LEON, WV 25123-5774
(304) 812-8198
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
37787
WV
Other
Enumeration date
10/06/2022
Last updated
10/06/2022
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