Individual
PAIGE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
2009037134
MO
363LA2200X
Adult Health Nurse Practitioner
53-75070-012
KS
363LP0200X
Pediatric Nurse Practitioner
Primary
2009037134
MO
363LP0200X
Pediatric Nurse Practitioner
53-75070-012
KS
363LP0200X
Pediatric Nurse Practitioner
R155784
MD
Other
Enumeration date
11/17/2006
Last updated
11/28/2012
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