Individual
MRS. DEBRA JEAN JOHNSON
Active
Individual
MRS. DEBRA JEAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F0499281
MO
364S00000X
Clinical Nurse Specialist
073423
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000050010
MEDICARE GROUP NUMBER
MO
01
—
268625
MEDICARE RHC GROUP NUMBER
MO
Enumeration date
05/17/2007
Last updated
07/24/2015
Update your record
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