Individual
ALYSIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
520 E 6TH ST, ODESSA, TX 79761-4527
(432) 582-8000
Mailing address
PO BOX 1627, STANTON, TX 79782-1627
(432) 661-3935
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
791930
TX
Other
Enumeration date
04/07/2016
Last updated
05/25/2016
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