Individual
DENISE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 BOLYN CT, MULLINS, SC 29574-2212
(843) 731-7463
Mailing address
115 BOLYN CT, MULLINS, SC 29574-2212
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F11180248
SC
Other
Enumeration date
09/19/2019
Last updated
02/22/2021
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