Doctor Name: | MARKEITA DANIELLE JOHNSON |
NPI Number: | 1124375266 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | AP122249 |
Business Practice Address: | 294 Uptown Blvd Suite 100 Cedar Hill, TX - 751043536 |
Business Phone Number: | 9722933569 |
Business Fax Number: | 9722999513 |
Mailing Address: | 294 Uptown Blvd, Suite 100 CEDAR HILL |
State: | TX |
Postal Code: | 751043536 |
Phone Number: | 9722933569 |
Fax Number: | 9722999513 |
NPI Enumeration Date: | 08/08/2012 |
NPI Last Update Date: | 03/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP122249 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |