Individual
MARY BRANTLEY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7900 OLD WAKE FOREST RD, RALEIGH, NC 27616-3319
(919) 790-1024
Mailing address
136 CRICKETGRASS DR, CARY, NC 27513-2764
(919) 889-2223
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5005703
NC
Other
Enumeration date
07/12/2012
Last updated
01/08/2014
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