Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP2300X | Nurse Practitioner - Primary Care | 639757 | TX |
Y | 363LP2300X | Nurse Practitioner - Primary Care | AP119719 | TX |
NPI | 1063703510 |
---|---|
Provider Name | Mrs. Karen A Johnson |
First Address | Schertz, TX 78154-2929 |
Second Address | Schertz, TX 78154-2929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2011 |
Last Update Date | 30/01/2019 |