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Individual

MRS. VON-NICA W. JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CNM

Contact information

Practice address
1680 EAGLE HARBOR PKWY STE A, ORANGE PARK, FL 32003-4821
(904) 264-9555
(904) 215-7960
Mailing address
PO BOX 25317, TAMPA, FL 33622-5317
(813) 286-0033
(813) 282-1806

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP9233376
FL
367A00000X
Advanced Practice Midwife
Primary
APRN9233376
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004548000
FL
Enumeration date
02/06/2012
Last updated
07/24/2019
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