Individual
JOHNNA ROSE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
828 E 149TH ST, BRONX, NY 10455-4670
(347) 431-0154
Mailing address
828 E 149TH ST, BRONX, NY 10455-4670
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F405320
NY
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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