Individual
TANISHA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
94-450 MOKUOLA ST STE 100, WAIPAHU, HI 96797-3388
(808) 944-2882
Mailing address
198 KIELA PL UNIT 202, WAHIAWA, HI 96786-3341
(601) 942-6882
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
88247
HI
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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