Individual
MARCIA KAY JOHANSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2700 HEALING WAY, STE. 300, WESLEY CHAPEL, FL 33544
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
ARNP9342458
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011942700
—
FL
01
—
Y0M6G
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/05/2006
Last updated
04/01/2021
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