Individual
MAKENSIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PPCNP-BC
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 660-2450
Mailing address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 660-2450
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95000564
CA
Other
Enumeration date
04/24/2014
Last updated
09/22/2014
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