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Individual

MISS TINA M JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1 COURT SQ, WK STN 20-089, LONG ISLAND CITY, NY 11120-0001
(347) 957-1252
(347) 396-4360
Mailing address
1 COURT SQ, WK STN 20-089, LONG ISLAND CITY, NY 11120-0001
(347) 957-1252
(347) 396-4360

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F334061
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03627929
NY
Enumeration date
09/13/2006
Last updated
03/23/2017
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