Provider Demographics
NPI:1396460317
Name:JOHNSON, ZULMERICCE (FNP)
Entity type:Individual
Prefix:MRS
First Name:ZULMERICCE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2381 E UNIVERSITY DR STE 50
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-2390
Mailing Address - Country:US
Mailing Address - Phone:512-921-0102
Mailing Address - Fax:
Practice Address - Street 1:2381 E UNIVERSITY DR STE 50
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-2390
Practice Address - Country:US
Practice Address - Phone:972-987-0458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1037019207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine