Individual
MRS. DESTINY JANE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6110 SHALLOWFORD RD STE B, CHATTANOOGA, TN 37421-1894
(423) 499-1031
Mailing address
6110 SHALLOWFORD RD STE B, CHATTANOOGA, TN 37421-1894
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
85506
TN
Other
Enumeration date
06/24/2018
Last updated
06/24/2018
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