Aretha Diane Johnson FNP

NPI 1457798332 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1457798332
Gender Female
Enumeration Date 05/31/2013
Last Updated 01/23/2014
Entity Type Individual
Active Over 3 years ago
Practice Location
2321 N WISCONSIN AVENUE
PEORIA IL, 61603, US
Phone (309) 680-7600
Fax (309) 680-7637
Business Location
1701 W GARDEN STREET
PEORIA IL, 61605, US
Phone (309) 680-7600
Fax (309) 680-7637
Toxanomy
Taxonomy Code 363LF0000X
License State Illinois
License Number 209010440
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According to our database, Mrs. Aretha Diane Johnson FNP NPI is 1457798332, taxonomy code is 363LF0000X and license number is 209010440, license state is located at Illinois. Aretha Diane Johnson FNP physically located at 2321 N Wisconsin Avenue, Peoria IL, 61603. NPI Number Aretha Diane Johnson FNP has the Individual type.

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1457798332 NPI number is provided on an as is basis without warranty of any kind. 1457798332 is maintained by the National Plan & Provider Enumeration System. The contents of Aretha Diane Johnson FNP are for informational purposes only.