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Individual

MRS. ANGELA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
438 E VANN RD, SUITE 202, GREENEVILLE, TN 37743-7202
(423) 278-1712
(423) 278-1703
Mailing address
PO BOX 37087, BALTIMORE, MD 21297-3087
(828) 687-5616
(828) 650-8076

Taxonomy

Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
RD100377
TN
363LF0000X
Family Nurse Practitioner
Primary
APN6998
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33485101
TN
01
4062794
BLUE CROSS PROVIDER
05
7004058
NC
01
TN0100
JOHN DEERE PROVIDER
Enumeration date
05/22/2006
Last updated
10/05/2022
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