Individual
MRS. DIA LYNAE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4101 GLENHUNT RD, BALTIMORE, MD 21229-1705
(443) 558-8532
Mailing address
4101 GLENHUNT RD, BALTIMORE, MD 21229-1705
(443) 558-8532
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
R202400
MD
363LG0600X
Gerontology Nurse Practitioner
Primary
R202400
MD
Other
Enumeration date
01/14/2019
Last updated
10/01/2020
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