Individual
POLLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
59 COWTOWN RD, HINDMAN, KY 41822-9120
(606) 785-3175
(606) 785-9968
Mailing address
59 COWTOWN RD, HINDMAN, KY 41822-9120
(606) 785-3175
(606) 785-9968
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006484
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3006484
KENTUCKY LICENSE
KY
05
—
7100121060
—
KY
Enumeration date
06/30/2010
Last updated
05/14/2015
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