Female

Versie Johnson-mallard NP

Nurse Practitioner in Tampa, FL(View on Map)

Full Name

Versie Johnson-mallard NP

NPI Number

1245457829

NPI Type

Individual Provider

Gender

Female

Enumeration Date

04/18/2007

Specialties

(Taxonomies)

Code

363L00000X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

ARNP1949272

Contact
Information

Purpose

Mailing
Location

Address

3292 HAWKS RIDGE DR
12901 BRUCE B DOWNS BLVD # 22

City

Lakeland
Tampa

State

FL
FL

Postal Code

33810-4010
33612-4742

Country

US
US

Telephone Number

(863) 815-1675
(813) 974-7210

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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