Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP07768 | LA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP125607 | TX |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP07768 | LA |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP125607 | TX |
NPI | 1033522461 |
---|---|
Provider Name | Trenice Johnson |
First Address | Houston, TX 77079-2119 |
Second Address | Houston, TX 77009-1568 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2014 |
Last Update Date | 10/09/2020 |