Individual
ODETTE S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
324 ELM ST STE 202B, MONROE, CT 06468-2284
(203) 880-5335
Mailing address
71 ATWATER AVE, DERBY, CT 06418-1409
(203) 455-1545
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8169
CT
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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