Individual
PAMELA E JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
N1487 BRAVE ISLAND RD, KESHENA, WI 54135-9325
(920) 941-0395
Mailing address
N1487 BRAVE ISLAND RD, KESHENA, WI 54135-9325
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
78631-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38291800
—
WI
Enumeration date
02/03/2009
Last updated
02/03/2009
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