Individual
DAYLE E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
105 RIDGECREST, NIXA, MO 65714-7807
(417) 725-8250
(417) 725-8253
Mailing address
105 RIDGECREST, NIXA, MO 65714-7807
(417) 725-8250
(417) 725-8253
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2004000194
MO
Other
Enumeration date
10/17/2005
Last updated
09/05/2007
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