Individual
RANDALL JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2659 PEERY AVE, KANSAS CITY, MO 64127-1300
(816) 965-1138
(816) 581-5874
Mailing address
950 NW MAPLEWOOD CT, GRAIN VALLEY, MO 64029-7210
(812) 309-3144
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2009015348
MO
Other
Enumeration date
07/13/2018
Last updated
07/13/2018
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