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Individual

LESLIE JOHANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
2021 N MACARTHUR BLVD, 150, IRVING, TX 75061-2219
(972) 253-4208
Mailing address
2021 N MACARTHUR BLVD, 150, IRVING, TX 75061-2219
(972) 253-4208

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
738943
TX

Other

Enumeration date
06/19/2012
Last updated
06/19/2012
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