IndividualActive
Tialicka Johnson, WHNP-BC
NPI 1891159463 · Women's Health Nurse Practitioner · Holloman Afb, NM
Provider details
- NPI number
- 1891159463
- Entity type
- Individual
- Primary specialty
- Women's Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- WHNP-BC
- Sex
- Female
- Sole proprietor
- No
- License
- 24176717 (VA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
49 Mdg
280 David L Goldfein St
Holloman Afb, NM 88330-8273
Phone: (575) 572-3069
Approximate (ZIP-level) locationGet directions
Mailing address
49 Mdg
Holloman Afb, NM 88330-8273
Registry dates
- Enumerated
- 2016-04-11
- Last updated
- 2025-07-10
- Certified
- 2025-06-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.