Individual
STACEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
4301 W MARKHAM ST # 519, LITTLE ROCK, AR 72205-7101
(501) 526-7017
Mailing address
4301 W MARKHAM ST # 519, LITTLE ROCK, AR 72205-7101
(501) 733-2967
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
A003751
AR
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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