Individual
CHRISTINA CERISE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
302 E JAMES LEE BLVD, CRESTVIEW, FL 32539-2827
(850) 682-1002
Mailing address
12280 LAKE UNDERHILL RD, ORLANDO, FL 32825-5009
(850) 682-1002
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9240049
FL
363LF0000X
Family Nurse Practitioner
9240049
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307414500
—
FL
Enumeration date
06/01/2006
Last updated
02/02/2012
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