Healthcare Provider Details

I. General information

NPI: 1275887259
Provider Name (Legal Business Name): CLAUDIA L JOHNSON APN, RNC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST
DOVER DE
19901-3530
US

IV. Provider business mailing address

319 BEECHWOOD AVE
DOVER DE
19901-5234
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-4067
  • Fax:
Mailing address:
  • Phone: 302-674-4067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberL10008312
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberLH-0000110
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: