Individual
MRS. ARETHA DIANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2321 N WISCONSIN AVENUE, PEORIA, IL 61603
(309) 680-7600
(309) 680-7637
Mailing address
1701 W GARDEN STREET, PEORIA, IL 61605
(309) 680-7600
(309) 680-7637
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209010440
IL
Other
Enumeration date
05/31/2013
Last updated
01/23/2014
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