Individual
DOMINIQUE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2201 CLEAR CREEK RD, KILLEEN, TX 76549-4110
(254) 519-8103
Mailing address
2201 CLEAR CREEK RD, KILLEEN, TX 76549-4110
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1157929
TX
363LF0000X
Family Nurse Practitioner
1157929
TX
Other
Enumeration date
07/18/2024
Last updated
08/01/2024
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