Individual
KYSHIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
623 W HAMILTON ST, ASHDOWN, AR 71822-3203
(870) 667-2100
Mailing address
623 W HAMILTON ST, ASHDOWN, AR 71822-3203
(870) 667-2100
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R108157
AR
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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