Mary Agnes Johnson
Nurse Practitioner
1400 8th Ave
Fort Worth
, Texas 76104-4110
Mary Agnes Johnson
Nurse Practitioner
1400 8th Ave
Fort Worth
, Texas 76104-4110
(334) 744-0554
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About
Features
Specialties
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Mary Agnes Johnson
- 2900 Willing Ave
- Fort Worth, TX
- Zip : 76110-3446
- Phone : (334) 744-0554
Second Address
- Mary Agnes Johnson
- 1400 8th Ave
- Fort Worth, TX
- Zip : 76104-4110
- Phone : (817) 922-7070
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 834891 | TX |
National Provider Identifier
| NPI | 1003251539 |
|---|---|
| Provider Name | Mary Agnes Johnson |
| First Address | Fort Worth, TX 76110-3446 |
| Second Address | Fort Worth, TX 76104-4110 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/05/2013 |
| Last Update Date | 10/05/2013 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.