Alicia L Johnson, FNP-C
Nurse Practitioner, Family in Elbridge, NY. Individual provider (NPI-1).
NPI number1003563768
StatusActive
Last updated in NPPESFeb 8, 2024
Details
- NPI
- 1003563768
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Alicia L Johnson
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 3, 2022
- Certification date
- Feb 8, 2024
- Last updated
- Feb 8, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F347820 | NY | Yes |
Practice location
5566 Jordan RdElbridge, NY 13060-9617
Phone 315-689-1833 · Fax 315-389-1834
Mailing address
1001 W Fayette St Ste 400Syracuse, NY 13204-2866
Phone 315-937-3026 · Fax 315-937-3126
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