Individual
STEPHANIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
72 NORMAN ST, EAST ORANGE, NJ 07017-3415
(646) 639-4087
Mailing address
72 NORMAN ST, EAST ORANGE, NJ 07017-3415
(646) 639-4087
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
337860
NY
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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