Individual
MRS. MELISSA D. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
187164
CO
363LP0200X
Pediatric Nurse Practitioner
Primary
0994145
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60689871
—
CO
Enumeration date
09/12/2008
Last updated
03/03/2020
Update your record
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