Individual
ANITRA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4230 11TH ST, ROCK ISLAND, IL 61201-6746
(309) 788-4571
(309) 788-7132
Mailing address
5901 ELMORE AVE APT K7, DAVENPORT, IA 52807-3592
(563) 210-6871
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
041473737
IL
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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