| Doctor Name: | VINCENT B. JOHNSON |
| NPI Number: | 1053717082 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APRN |
| License Number: | 19182 |
| Business Practice Address: | 110a Springhall Dr Goose Creek, SC - 294455335 |
| Business Phone Number: | 8432662520 |
| Business Fax Number: | 8435534436 |
| Mailing Address: | Po Box 118008, NORTH CHARLESTON |
| State: | SC |
| Postal Code: | 294238008 |
| Phone Number: | 8432662520 |
| Fax Number: | 8435534436 |
| NPI Enumeration Date: | 11/19/2014 |
| NPI Last Update Date: | 04/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 19182 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |