Individual
MR. JOHNNIE DARRYL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
811 W BALTIMORE ST, GREENWOOD, AR 72936-4544
(479) 597-8434
Mailing address
811 W BALTIMORE ST, GREENWOOD, AR 72936-4544
(479) 597-8434
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
050283161209E
AR
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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