Individual
MRS. DIANA JEAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN285127
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002026602
MEDICARE PTAN
MA
01
—
55448
HEALTH NEW ENGLAND
MA
Enumeration date
01/05/2011
Last updated
11/02/2012
Update your record
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