Individual
TINA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33399 WALKER RD STE B, AVON LAKE, OH 44012-1481
(419) 617-0085
Mailing address
33399 WALKER RD STE B, AVON LAKE, OH 44012-1481
(440) 465-9392
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0034711
OH
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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