Individual
DE'LA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
PO BOX 1268, NEW SMYRNA BEACH, FL 32170-1268
(386) 259-8803
(386) 213-9981
Mailing address
PO BOX 1268, NEW SMYRNA BEACH, FL 32170-1268
(386) 259-8803
(386) 213-9981
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
APRN11029119
FL
208VP0000X
Pain Medicine Physician
Primary
APRN11029119
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APRN1029119
—
FL
Enumeration date
10/11/2023
Last updated
07/12/2024
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