Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 201393630NP-PP | OR |
NPI | 1003223264 |
---|---|
Provider Name | Dr. Barbara Johnson |
First Address | Eugene, OR 97405-2767 |
Second Address | Eugene, OR 97401-2186 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2014 |
Last Update Date | 02/10/2020 |