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Individual

MARY ELIZABETH JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-8473
(319) 356-2587
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-8473
(319) 356-2587

Taxonomy

Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
J053450
IA
363L00000X
Nurse Practitioner
Primary
J053450
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0420596
IA
01
04876
WELLMARK BCBS
IA
Enumeration date
09/23/2005
Last updated
12/11/2007
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