NPI 1114692159

Gloria Omar Johnson

Practitioner Licensed Practical Nurse Richmond, VA

Practice location

Address: 4926 W Broad St, Richmond, VA 23230-3122
Phone: (804) 673-5241
Mailing address: 602 Milton St, Richmond, VA 23222-2843

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence 0002023000 (VA)

Other Licensed Practical Nurse providers in Virginia →

Registry record

NPI: 1114692159
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Aug 2021
Record last updated: 11 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.