Most Relevant Information
Provider Data
| NPI Number: | 1003679804 |
| Provider Name: | RAESHAUNA JOHNSON NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP2300X |
| Specialty: | Nurse Practitioner |
| License Number: | 227318 |
Most Important Dates
| Enumeration Date: | 02/05/2024 |
| Last Updated: | 02/05/2024 |
Provider Practice Location
8 WILD BERRY PL
LITTLE ROCK
AR
722105653
Practice Location Phone/Fax
| Phone: | 5014781504 |
| Fax: |
Provider Mailing Location
8 WILD BERRY PL
LITTLE ROCK
AR
722105653
Provider Mailing Phone/Fax
| Phone: | 5014781504 |
| Fax: |