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Individual

MRS. RAY VIVIAN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
4632 WILLOW AVE, KANSAS CITY, MO 64133-1847
(816) 616-7179
Mailing address
4632 WILLOW AVE, KANSAS CITY, MO 64133-1847
(816) 616-7179

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
143504
MO

Other

Enumeration date
01/28/2009
Last updated
01/28/2009
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