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Individual

MS. TIESHA TAMARA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
2322 S PALMETTO AVE, SOUTH DAYTONA, FL 32119-3093
(386) 864-5232
Mailing address
2322 S PALMETTO AVE, SOUTH DAYTONA, FL 32119-3093

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9672022
FL

Other

Enumeration date
06/19/2026
Last updated
06/19/2026
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