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NPI Code Detail

MEDICARE: MRS. TIFFANY SHEARN JOHNSON PA

MEDICARE: MRS. TIFFANY SHEARN 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
1363AM0700XMedical Physician Assistant0010-00276NC

General Provider Information

NPI Number : 1588603591
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY SHEARN JOHNSON PA
Provider Business Mailing Address
First Line : 300 BETHESDA DR
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-7218
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 BETHESDA DR
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-7218
Country : US
Telephone Number : 252-752-7141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2006
Last Update Date : 07/16/2014

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Directions to “ MRS. TIFFANY SHEARN JOHNSON PA” Practice Location

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