Individual
NANCY BANFIELD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
217 N AURORA ST, ITHACA, NY 14850-4345
(607) 273-2811
Mailing address
10 MORTON RD, VAN ETTEN, NY 14889-9724
(607) 589-6381
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F300298-01
NY
Other
Enumeration date
07/16/2020
Last updated
11/17/2020
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