Doctor Name: | MS. TONYA LEE JOHNSON |
NPI Number: | 1679825152 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | AP8445 |
Business Practice Address: | 108 Arizona St Bisbee, AZ - 856031804 |
Business Phone Number: | 5204323309 |
Business Fax Number: | |
Mailing Address: | 155 Calle Portal, Suite 100 SIERRA VISTA |
State: | AZ |
Postal Code: | 856352900 |
Phone Number: | 5204593012 |
Fax Number: | |
NPI Enumeration Date: | 10/09/2012 |
NPI Last Update Date: | 06/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP8445 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |