Individual
MRS. DOLORES LORRAINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
293 INDEPENDENCE BLVD, BLDG 5 SUITE 330, VIRGINIA BEACH, VA 23462-5402
(757) 499-4949
(757) 499-0648
Mailing address
PO BOX 61094, VIRGINIA BEACH, VA 23466-9998
(757) 499-4949
(757) 499-0648
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024164367
VA
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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