Individual
LANNETTE DENISE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
7853 1/2 CRENSHAW BLVD, LOS ANGELES, CA 90043-4940
(323) 747-3490
Mailing address
7853 1/2 CRENSHAW BLVD, LOS ANGELES, CA 90043-4940
(323) 747-3490
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
652970
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
95005777
CA
Other
Enumeration date
11/28/2016
Last updated
12/29/2016
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