Individual
MRS. VICTORIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PN1276041, 84847
Contact information
Practice address
6166 PLAINS DRIVE, LAKE WORTH, FL 33463
(561) 307-3440
Mailing address
PO BOX 603, JUPITER, FL 33468
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
84847
NC
164W00000X
Licensed Practical Nurse
Primary
PN1276041
FL
Other
Enumeration date
09/13/2017
Last updated
03/17/2018
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