Individual
TISHEKA MONAY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3409 ASTOR AVE, PORTSMOUTH, VA 23704-6010
(910) 431-0040
(757) 673-0045
Mailing address
3409 ASTOR AVE, PORTSMOUTH, VA 23704-6010
(910) 431-0040
(757) 673-0045
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
Q9Z4L4W4
VA
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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