Doctor Name: | MAUREEN LORRAINE GAY JOHNSON |
NPI Number: | 1205167046 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | SP010677 |
Business Practice Address: | 1829 Bustleton Pike Visiting Physicians Of Thedelaware Valley, Llc Feasterville, PA - 19053 |
Business Phone Number: | 2153648412 |
Business Fax Number: | 2153648730 |
Mailing Address: | 517 N Ramunno Dr, MIDDLETOWN |
State: | DE |
Postal Code: | 197093047 |
Phone Number: | 2153648412 |
Fax Number: | 2153648730 |
NPI Enumeration Date: | 01/19/2010 |
NPI Last Update Date: | 01/19/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | SP010677 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |