Individual
MELISSA KAY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
58 LILLY DR, CULLODEN, WV 25510-7281
(304) 239-9120
Mailing address
58 LILLY DR, CULLODEN, WV 25510-7281
(304) 239-9120
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
107447
WV
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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