Individual
JUANITA F. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
4201 BROOK SPRING DR, DALLAS, TX 75224-4968
(214) 266-1400
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
691773
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196034601
—
TX
05
—
196034602
—
TX
05
—
196034603
—
TX
05
—
196034604
—
TX
05
—
196034605
—
TX
05
—
196034606
—
TX
05
—
196034607
—
TX
05
—
196034608
—
TX
05
—
196034609
—
TX
05
—
196034610
—
TX
01
—
8Y5364
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/28/2006
Last updated
04/29/2011
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