Doctor Name: | MS. JOHANNA LYNNE EVERETT |
NPI Number: | 1225305022 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 26NJ00350200 |
Business Practice Address: | 1 Capital Way Pennington, NJ - 085342520 |
Business Phone Number: | 6095376000 |
Business Fax Number: | |
Mailing Address: | 1 Capital Way, PENNINGTON |
State: | NJ |
Postal Code: | 085253425 |
Phone Number: | 6095376000 |
Fax Number: | |
NPI Enumeration Date: | 11/22/2011 |
NPI Last Update Date: | 11/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 26NJ00350200 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |