Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP9264803 | FL |
NPI | 1043562341 |
---|---|
Provider Name | Ms. Easter Johnson |
First Address | Orlando, FL 32806-1051 |
Second Address | Orlando, FL 32806-1051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2012 |
Last Update Date | 09/09/2021 |