Doctor Name: | MRS. BERNICE DAVIS JOHNSON |
NPI Number: | 1063625796 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | 18341 |
Business Practice Address: | First Avenue And Logan Street Williamson, WV - 25661 |
Business Phone Number: | 3042353570 |
Business Fax Number: | 3042352654 |
Mailing Address: | 222 Joseph Ave, WILLIAMSON |
State: | WV |
Postal Code: | 256613323 |
Phone Number: | 3042352796 |
Fax Number: | |
NPI Enumeration Date: | 05/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC1500X |
License Number: | 18341 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |