Individual
SALLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
136 MILL ST, PRINCETON, ME 04668-3344
(207) 796-5503
(207) 796-5528
Mailing address
136 MILL ST, PRINCETON, ME 04668-3344
(207) 796-5503
(207) 796-5528
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R030799
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134200702
—
ME
Enumeration date
12/14/2005
Last updated
12/03/2022
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