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Individual

CHRISTY T JOHNSON-OLIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
213 N MAIN ST, BLACKSTONE, VA 23824-1425
(434) 292-7261
(434) 292-7965
Mailing address
7229 FOREST AVE STE 112, RICHMOND, VA 23226-3765
(804) 281-0275
(804) 521-9344

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
0024175489
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C09633
MEDICARE PTAN
VA
Enumeration date
10/06/2017
Last updated
06/16/2018
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