Individual
BONITA D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
241 KELLEY ST, LAKE CITY, SC 29560-2446
(843) 394-1051
(843) 394-0277
Mailing address
360 N IRBY ST, FLORENCE, SC 29501-2808
(843) 667-9414
(843) 667-1362
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18176
SC
Other
Enumeration date
05/21/2013
Last updated
06/02/2016
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