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Individual

ALLISON JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
816 FAIRMOUNT AVE, JAMESTOWN, NY 14701-2545
(716) 969-3378
Mailing address
27 MAPLEVIEW AVE, LAKEWOOD, NY 14750-1621
(716) 969-3378

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
630594
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382372
NY

Other

Enumeration date
12/16/2012
Last updated
01/31/2014
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