Individual
MRS. IVONNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
201 N PARK AVE STE 105, APOPKA, FL 32703-4147
(407) 889-1953
(407) 303-0845
Mailing address
201 N PARK AVE STE 105, APOPKA, FL 32703-4147
(407) 889-1953
(407) 303-0845
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN2171042
FL
363LP0200X
Pediatric Nurse Practitioner
APRN2171042
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303832700
—
FL
01
—
500017673
RAILROAD MEDICARE
—
01
—
Y0033
BCBS
FL
Enumeration date
06/14/2006
Last updated
08/19/2020
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