Individual
MRS. ASHLEY DIANE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3068 COUNTY ROUTE 46, FORT EDWARD, NY 12828-3404
(518) 932-5983
Mailing address
3068 COUNTY ROUTE 46, FORT EDWARD, NY 12828-3404
(518) 932-5983
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
280591-1
NY
Other
Enumeration date
05/30/2012
Last updated
05/30/2012
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