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Individual

MRS. LISA ANN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4940 CORRALES RD STE 125, CORRALES, NM 87048-8682
(505) 433-4446
Mailing address
4940 CORRALES RD STE 125, CORRALES, NM 87048-8682
(505) 433-4446

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
368977-4405
UT
363LP2300X
Primary Care Nurse Practitioner
Primary
54024
NM

Other

Enumeration date
09/14/2006
Last updated
11/24/2019
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