Doctor Name: | ALICIA M JOHNSON |
NPI Number: | 1295015543 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 68520 |
Business Practice Address: | 285 Church St Clay, WV - 250439413 |
Business Phone Number: | 3045874266 |
Business Fax Number: | |
Mailing Address: | 501 22nd St, DUNBAR |
State: | WV |
Postal Code: | 250641711 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/18/2011 |
NPI Last Update Date: | 08/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WS0200X |
License Number: | 68520 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | School |
Taxonomy Definition: |