Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN.CNP.024139 | OH |
NPI | 1003059072 |
---|---|
Provider Name | Mrs. Tonya Tressa Johnson |
First Address | Reynoldsburg, OH 43068-8193 |
Second Address | Reynoldsburg, OH 43068-8193 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2009 |
Last Update Date | 10/07/2020 |