Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | LP-0000122 | DE |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | LP-0000122 | DE |
N | 363LG0600X | Nurse Practitioner - Gerontology | LP-0000122 | DE |
NPI | 1407196447 |
---|---|
Provider Name | Sharmila Sharmalee Johnson |
First Address | Bear, DE 19701-2279 |
Second Address | Newark, DE 19718-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2013 |
Last Update Date | 31/05/2017 |