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NPI Code Detail

MEDICARE: SHEILA JOHNSON PA

MEDICARE: SHEILA JOHNSON PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA471KY

General Provider Information

NPI Number : 1023061231
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEILA JOHNSON PA
Provider Business Mailing Address
First Line : 1306 VERSAILLES RD STE 120
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-1795
Country : US
Telephone Number : 859-259-2635
Fax Number :
Provider Business Practice Location Address
First Line : 1306 VERSAILLES RD STE 120
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-1795
Country : US
Telephone Number : 859-259-2635
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 03/03/2025

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Directions to “ SHEILA JOHNSON PA” Practice Location

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