Individual
TIARA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1177 PLOVER CIR, PONDER, TX 76259-5473
(972) 567-1034
Mailing address
PO BOX 664, FRISCO, TX 75034-0012
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
945325
TX
163WC0400X
Case Management Registered Nurse
945325
TX
163WW0101X
Ambulatory Women's Health Care Registered Nurse
945325
TX
171M00000X
Case Manager/Care Coordinator
Primary
945325
TX
Other
Enumeration date
05/21/2024
Last updated
10/10/2024
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