Individual
JOHNNY LEE HEDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AG-ACNP-BC
Contact information
Practice address
102 N MAGDALEN ST, SAN ANGELO, TX 76903-5400
(325) 655-2200
Mailing address
102 N MAGDALEN ST, SAN ANGELO, TX 76903-5400
(325) 655-2200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1099256
TX
Other
Enumeration date
11/18/2022
Last updated
11/18/2022
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