Individual
LATISHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 GUSTAVE L. LEVY PLACE, NEW YORK, NY 10029-6574
(347) 208-3915
Mailing address
1001 MADISON ST APT 301, HOBOKEN, NJ 07030-6486
(347) 208-3915
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3096777
NY
Other
Enumeration date
06/11/2020
Last updated
10/17/2020
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