Individual
DIANA MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, QMRP, CHSP
Contact information
Practice address
495 S 16TH ST, COTTAGE GROVE, OR 97424-2339
(541) 767-3693
(541) 767-3693
Mailing address
495 S 16TH ST, COTTAGE GROVE, OR 97424-2339
(541) 767-3693
(541) 767-3693
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
087000178RN
OR
Other
Enumeration date
09/21/2011
Last updated
09/21/2011
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