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Individual

LISA A JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 647-6006
Mailing address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 647-6006

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN48703
WV
364SM0705X
Medical-Surgical Clinical Nurse Specialist
48703
WV

Other

Enumeration date
06/16/2009
Last updated
07/06/2023
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