Stacy Nicole Johnson

NPI #1235672189 in Wilmer, Texas

Provider Information

NPI Number: 1235672189
Entity Type: Individual
Name: Stacy Nicole Johnson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Contractor
Enumeration Date: Nov 27, 2016
Last Updated: Nov 27, 2016

Practice Location

Address: 259 GREEN MEADOWS RD
City: Wilmer
State: Texas
ZIP Code: 75172-3336
Phone: (469) 231-4293

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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