Organization Name: | WENDY D. JOHNSON ARNP LLC |
NPI Number: | 1265716948 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WENDY D JOHNSON (PRACTITIONER) |
Mailing Address: | 19500 128th Ave Se Yelm |
State: | WA US |
Postal Code: | 985977651 |
Phone Number: | 3608947556 |
Fax Number: | |
NPI Enumeration Date: | 09/29/2011 |
NPI Last Update Date: | 09/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP60229317 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |