ELLIOT LAINE JOHNSON
Individual Provider (NPI-1)
Active
Registered Nurse, Critical Care Medicine
Provider Information
- NPI Number
1871419861- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV, 253091311
- Phone
- (304) 610-5087
Specialties & Taxonomies
Registered Nurse, Critical Care Medicine
Primary License: WV #99235